18. What assessment he has made of the potential role of (a) competition and (b) co-operation and collaboration in the NHS. (57829)

Co-operation and competition both have important roles to play in improving services for patients. We want to see better integration of services to improve quality and increase choice for patients. Following the listening exercise, we are awaiting the report on the best way forward.

The Deputy Prime Minister says that he wants Monitor to promote co-operation and collaboration, while the Secretary of State says that competition can lead to a far greater degree of integration. It is good that the Deputy Prime Minister has finally caught up with the views of the public and health professionals—but which of those fundamentally contradictory views will end up in the Bill?

First, we all want co-operation and competition based on quality. We have had a listening event, and we are awaiting the recommendations of the forum set up under Professor Steve Field. Until we see that report, we cannot comment. I can tell the hon. Lady, however, that we do not want the kind of system of competition in the health service that leads to an independent sector treatment centre in Nottingham being paid 18% more than the NHS for the services provided, and getting £5.6 million for not doing a single operation.

Does my right hon. Friend agree that a key focus for improving collaboration in the NHS must be to break down the silo working that occurs between adult social services and the NHS? That will be particularly pertinent in improving elderly care services and mental health care services, and in providing a community focus for that care.

Yes—and it is always refreshing to get a question from someone who has had experience of working in the NHS and actually knows what he is talking about. My hon. Friend is absolutely right; greater integration of services is crucial if we are to break down the barriers and get improved, high-quality care for all patients.

I was interested to hear the Minister’s earlier answer to my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) about the situation in Trafford. Will he confirm that he will encourage a collaborative approach, involving the strategic health authority, the primary care trust, the existing foundation trust and the potential bidding foundation trust, to secure the best possible clinical and financial outcome for patients?

Yes, I can tell the hon. Lady that it will be up to the SHA, the trust and officials at the Department—[Interruption.] The SHA is the strategic health authority in the north-west. It is for them to work together to produce a tripartite formal agreement—when agreed, it will be published for the local community to see—as the best way forward to seek solutions and to help trusts achieve foundation trust status. It is in their interest and the interest of patients to bring about improved, high-quality patient care.