Cities and Local Government Devolution [Lords] Bill

If the mayor was to have responsibility for the services—that is not the proposal for Greater Manchester—the mayor would only have responsibility for the services within the combined area. Anything beyond that would still fall within the remit of those who commissioned services in that area. The decision as to—[Interruption.] That is right: the hospital in that circumstance may well have two bosses because the CCG would be responsible for the whole lot and it would have to come, by agreement, to a decision as to what was being provided within the combined area as well as outside the combined area. So the CCG remains responsible for what it is delivering, but it decides as normal with those to whom it is answerable—in one area it has become a different authority and in another it remains the original one—what services they should provide. The overall security for the quality of what the CCG is providing is maintained by the national regulator, which supervises, and it is ultimately for the Secretary of State to make sure the NHS guidance and duties are not breached, but it is a matter for local decision how this coterminosity is dealt with, because it will occur in more than one area. Certainly, however, I cannot see that legally a CCG outside a combined authority could have any direct line of responsibility to somebody inside the combined authority who is making decisions not about their area. That is how that would work.