My Lords, I wish to speak to my Amendments 43A and 43B. I start by thanking the Minister and the Secretary of State for the amount of time they have afforded to me in discussing the concerns that lie behind my amendments. It is indeed correct that I was concerned that one clinical commissioning group commissioning from a failing trust could have a disproportionate say over the future. The government amendment, as tabled, addresses those concerns and I am most grateful to the Government for it. It establishes parity of commissioners by ensuring that there is no harm to essential services. I am also
relieved that the Government are stating that the same legal criterion will be applied. Therefore, standard-setting across the services will establish that parity.
One of my concerns relates to the guidance. I would be grateful if the Minister could confirm that the committee of which Paul Burstow is the proposed chair will continue to exist. I think that there has been a lack of confidence among the public as a result of the publicity surrounding what happened at Lewisham. It will be very important that the guidance is seen to be drawn up and reported on separately. I must admit that I am uncertain about the mechanism for that. However, I certainly would be concerned if the detail of how the process is laid out is not openly and independently reviewed. The current guidance has to be rewritten anyway and that process could restore public confidence.
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I am also grateful to the Minister for having laid out clearly all the mechanisms that should be in place prior to the trust special administration being brought in, because that clarifies that the process cannot be used as a mechanism for reconfiguration. Reconfiguration should be through the commissioning processes but may be necessary when there is a failing trust—and indeed, there will be a need for changes in services. Service provision is dynamic: there is no fixed footprint for any service, and as advances happen in medicine and clinical care the place and the way that services are delivered will inevitably alter. However, good commissioning should adapt and allow those changes to happen without ever ending up with the trust special administration process having to be invoked.
I am grateful to the Government for having accepted my amendment. I understand why the last part of it was not taken up by them and actually agree with them because a consultation process has to have some time limits around it. The danger with the amendment as I had tabled it was that the consultation process could run and run and could stifle decision-making and end up effectively putting a planning blight on services and causing a deterioration in standards rather than a rectification of low standards and a raising of standards again. With that, I would like to say that I will not press my amendments.