At the NHS Confederation’s annual conference in Manchester on Friday, Lord Phillip Hunt, Labour peer and shadow deputy leader of the House of Lords, said clinical commissioning groups must be made accountable as they will be handed 'enormous' budgets.
He said there will be a ‘lot of focus’ on GP performance in the House of Lords debates, as a ‘problem’ within the current plans is that clinical commissioning groups do not have any levers to ensure their constituent GPs comply with their aims.
Lord Hunt also said that although the health and wellbeing boards are the ‘big winners’ following the listening exercise, many in the House of Lords will seek to enhance their role to be the ‘key decision makers’ locally.
He said: ‘Given all the fog about who’s going to make decisions in the future it will be very tempting to look at those health and wellbeing boards as a body that will bring all of this together.’
The role of competition and Monitor will be the ‘big debate’ in the House of Lords, he said, outlining that there will be a ‘lot of effort’ made to give Monitor a much ‘stronger remit’ around integration.
Lord Hunt, meanwhile, said that whether the House of Lords inflicts ‘real damage’ on the Health Bill will depend on what the NHS and its stakeholders make of the changes to the Bill.
He added that it will also be influenced by the BMA’s campaign to drop the Bill and whether this translates into ‘strong pressure’ to take key clauses out of the legislation, such as the sections around competition.
It comes as Liberal Democrat peer Baroness Shirley Williams said the government held a ‘genuine’ listening exercise, and the NHS Future Forum’s report did a ‘good job’ of isolating concerns.
But she said there are still issues that have yet to be ‘seriously addressed’, including ambiguity around the role of choice and competition.
She also said the Health Bill’s provisions around the training of doctors is ‘very sketchy’, warning that it would be ‘very foolish’ to abolish deaneries.
Baroness Williams also denied accusations that the amended Health Bill is a ‘done deal’ for Liberal Democrats, outlining that it is still ‘in play’.