Health and Social Care Bill

Debate between Lord Rea and Baroness Tonge

Wednesday 2nd November 2011 Lords Chamber

[Lord Rea]

My Lords, the noble Baroness, Lady Finlay, has somewhat stolen my thunder because I had meant to say almost exactly what she said, but I was going to mention it when we got to the part of the Bill describing the clinical commissioning groups. Schedule 2, which relates to clinical commissioning groups, states:

“A clinical commissioning group must have a constitution … The constitution must specify”,

the name, the members and the area of the group. That is there. I would like the noble Earl to describe how that area is to be measured and whether it is to be coterminous with existing boundaries, particularly local authority boundaries, for the very reason given by the noble Baroness, Lady Finlay.

[Baroness Tonge]

My Lords, most of the points I wanted to raise have already been raised so I will not repeat them. I congratulate the noble Baroness, Lady Finlay, on her comprehensive overview of her amendments. What concerns me most is those patients who fall through the net of the new general practice commissioning groups. If it is not area-based and there is not a primary care trust responsible for allocating those patients, where will people who do not speak English very well, asylum-seekers, the homeless, mentioned by the noble Baroness, and Travellers go? What about those patients whom I remember well, whom most GP practices did not want on their lists at all and who were rotated around general practices in order that they got medical treatment? What will happen to all those patients? There are many of them and some of them have severe disabilities and some are severely mentally ill. They fall into all sorts of groups. I am extremely concerned that without an area base or a responsibility on a PCT or a commissioning group to deal with patients in a particular geographical area, those patients will suffer hugely.

I want to make one final point. The other service that will suffer hugely is our accident and emergency departments, because if those people do not have GPs, that is where they will go. I was a casualty officer in central London for a whole year, once upon a time, and I virtually ran a general practice there then for patients who were unattached to general practices. That problem will increase, and I hope that the Minister will address that in his comments.