Business of the House

John Bercow Excerpts

Thursday 13th December 2012 Commons Chamber

[Several hon. Members]

rose—

[Mr Speaker]

Order. It is a curious phenomenon in the House that when there are fewer Members standing—and fewer are standing today than is often the case at business questions—exchanges seem to lengthen to absorb available time. May I gently exhort the House to be pithy because there is a statement to follow and other business. If we can treat these matters succinctly, that would help.

[Nick Smith (Blaenau Gwent) (Lab)]

May we please have a statement on undiagnosed cleft palates in new babies? The Royal College of Surgeons has found wide variations across the UK. In North Thames, only 42% of cleft palates are identified at birth, whereas in Oxford the figure is 94%. The Government really must do better by mums and babies on this issue.

--- Later in debate ---

[Tessa Munt (Wells) (LD)]

The right hon. Gentleman will know of my interest in cancer and that I am generally supportive of the idea that doctors and clinicians should make decisions about local commissioning. Last night, however, I finished reading “Securing equity and excellence in commissioning specialised services”, a document produced by the NHS Commissioning Board. It is 227 pages long, and I was stunned to learn that there are 130 specialised commissioning services groups and a series of subgroups, as well as the NHS Commissioning Board, four regional directorates and 10 sub-regional directors inside 27 local area action teams. I am unclear how introducing more bureaucracy and new layers of staff—who are appointed, not elected—will lead to an increase in the provision of local services.

[Mr Speaker]

We are ever so grateful to the hon. Member for Wells (Tessa Munt), who might wish further to pursue this matter by the well-known device of an Adjournment debate.

[Mr Lansley]

The commissioning of specialised services through the NHS Commissioning Board is a direct replacement for the previous regional or national specialised commissioning. I have to tell my hon. Friend that the level of bureaucracy she describes is significantly less than there used to be under regional and national specialised commissioning. The total activity in the NHS Commissioning Board, compared with the responsibilities it has taken on, is reducing by about 30% or 40%; I am talking about the number of people employed and engaged in that kind of central commissioning activity. People with some of these specialised conditions want specialised commissioning on a national basis, because it gives them much greater assurance about the consistent application of the clinical guidelines.