2. What safeguards are in place for the sustainability of NHS facilities when clinical commissioning groups contract out local services. (905539)

The previous Government introduced greater competition to the NHS. This Government have ensured that it is for local doctors and nurses through clinical commissioning groups, rather than bureaucrats, to decide how best to procure NHS services in the interests of their patients.

As the Minister is aware, Coastal West Sussex CCG is controversially proposing to award a major contract for musculo-skeletal services to a social enterprise consortium rather than Worthing hospital. While I welcome new ways of working in the NHS, as long as the quality of care for patients remains key, what safeguards are in place to ensure that existing NHS services such as trauma and accident and emergency, which we campaigned so hard to protect at Worthing hospital, are not compromised?

The Health and Social Care Act 2012 ensures that commissioners must also have regard to delivering integrated health care services. I reassure my hon. Friend that the West Sussex CCG has clearly stated:

“The…CCG will continue to commission MSK related trauma from the current providers and the intention is for this to continue for the duration of this MSK…contract”.

23. What is the Minister doing to retain GPs as there is considerable concern in Coventry about the number who are leaving practice? (905562)

I hope that I can reassure the hon. Gentleman that there are now 1,000 more GPs in training and working in the NHS under this Government than when we came to power in 2010. We are committed to training even more GPs to ensure that we can widen access to general practice services.

In what circumstances can clinical commissioning groups treat the NHS as a preferred provider, and in what circumstances are they forced to contract out services?

As my hon. Friend will be aware, when commissioning services, it is important that regard is given not only to competition because, under the 2012 Act, we have ensured that there must be regard to delivering an integrated and joined-up approach for local services. That is an issue for local commissioners to decide in the best interests of the patients they look after.

Are not certain CCGs starting to merge decision-making processes, meaning that some important strategic decisions are removed even further from local communities and there is therefore a complete lack of accountability?

For some more specialist services, collaboration between various parts of the local NHS will always be needed. That is about good health care commissioning and ensuring that services are joined up in a collaborative way. Whereas day-to-day, bread-and-butter services will be commissioned by a local CCG, for more specialist services, clinical commissioners will of course need to work together to ensure that local centres of excellence are commissioned.

The sustainability of NHS facilities is often prejudiced by the millstone of Labour’s private finance initiative deals. What is the Government’s expectation of how CCGs should make the best of the hand that they have been dealt?

My hon. Friend is absolutely right that PFI deals signed by the previous Government have crippled the finances of many hospital trusts, meaning that many of them are unable to invest as much in front-line patient care as they would like. It is important that the Government support the mitigation of PFI deals, when possible, and we have a group that is doing exactly that and supporting local commissioners to deal with the worst excesses of the previous Government’s mismanagement of the NHS finances.