Lord Lansley (Con)

My Lords, before we complete this group, I just want to say that what the noble Lord, Lord Hunt of Kings Heath, said by way of moving his probing amendment asks not only important questions but questions to which we will have to come back, if not in this Bill then on the NHS reform Bill. As I know the noble Lord will completely understand, in so far as that forthcoming legislation will transfer responsibilities back into the Department of Health and Social Care and, potentially, give specific statutory responsibilities to integrated care boards, neither of those will allow this legislation and the 2016 legislation to operate in the way he intends. We will, therefore, have to come back to that and how it will happen at the time. As things stand, the Secretary of State for Health and Social Care does not devolve any of his functions to local government. In effect, he devolves the functions that would otherwise be exercised by NHS England in Manchester to the mayoral strategic authority. If we are going to do that in other mayoral strategic authorities when NHS England has disappeared, there will need to be a new structure to see how this works. In some ways, it is entirely dependent on how the Government intend, in the NHS reform procedures, to re-establish the relationship between the NHS and local government. Nobody—I heard the noble Lord say this quite recently—has satisfactorily created that relationship. In the coalition Government, it was a very complicated process, and it did not work. There have been positive outcomes in relation to public health, but, for local government, there have not been satisfactory outcomes in relation to the management of health services—particularly in so far as they can be combined satisfactorily with social care services. This is something that we will have to return to in the NHS reform Bill.