MPs have approved a motion to give clinical commissioning groups greater flexibility and control in the way that they work to commission healthcare services for their communities.
Minister of state for care and support Norman Lamb said the draft Legislative Reform Order sought to amend the NHS Act 2006 to allow clinical commissioning groups to form a joint committee when exercising their commissioning functions jointly.
But Labour accused the coalition of trying to fix “yet another problem” thrown up by its controversial health reforms, which passed into law in 2012.
Shadow minister for care and older people Liz Kendall said she was concerned the draft order was “not strong enough” and the joint committees would not be accountable to patients and the public.
She said: “The reason we’re actually here today is because we’re trying to clear up yet another problem created by the government’s NHS reorganisation and the Health and Social Care Act, which I think will go down in the annals of Parliamentary history as one of the worst pieces of legislation this House has seen.”
The government, Mr Lamb said, wanted to allow CCGs a route in which they could take decisions in a “properly constituted forum” when they were collaborating with other CCGs.
He said: “The proposed amendments build on existing powers by giving CCGs greater flexibility and control in the way that they work. They return in a sense to the arrangements that were in place with [primary care trusts]. The changes will support more effective and efficient joint working and allow discussions about service redesign to take place across the local health economy.”
He added: “The NHS Act already allows two or more CCGs to exercise their commissioning functions jointly but does not make any provision for them to do so via a joint committee.”
The order, he went on, would also allow CCGs to “exercise their commissioning functions jointly with NHS England and to form a joint committee when doing so. The Act already allows NHS England and CCGs to jointly exercise an NHS England function and to do so by way of a joint committee, but it makes no provision for them to jointly exercise a CCG function.”
The proposed arrangements, he said, would be voluntary, allowing CCGs to retain their autonomy and “continue to make decisions that are in the best interests of their local populations”.
He added: “At the moment the lack of provision for CCGs to form joint committees is placing a burden on CCGs and preventing them for working in the most effective and efficient way.”
Mr Lamb said that without the power to form joint committees, CCGs had to find other means of reaching joint decisions, adding: “That means they often end up seeking legal advice to ensure that they are on a firm footing, that adds to cost and complexity without a proper process in place.”
As an interim measure, some CCGs were forming committees in common.
The predecessors of CCGs, Primary Care Trusts were able to form joint committees at which participating PCTs were bound by decisions reached.
Ms Kendall argued autonomy had not been written into the draft order, potentially placing CCGs under pressure.
She said: “They are concerned that this draft order could take away their autonomy, forcing them into committees and decisions they don’t think are in the best interests of local people.”
She added: “Members on this side of the House repeatedly warned during the passage of the Act that CCGs would often be too small to secure the effective changes to services across wider areas.”
Labour, she said, supported “in principle” the need for collaboration and for CCGs to come together both with one another and with NHS England to commission services, but added “serious concerns” had been raised about the draft order by local Healthwatch organisations and Healthwatch England, among others.
The draft Legislative Reform (Clinical Commissioning Groups) Order 2014 motion was approved by 276 votes to 152, majority 124.