I’m writing this in the half hour break we’ve been given for lunch on the 5th day of committee on the Health and Social Care Bill. We’ve been discussing the role of GP Clinical Commissioning groups and then Public Health. There is broad unaniminity around the House about the objectives and very little disagreement about the aims of the policy but significant differences about the degree of latitude peers would like to give to those who will have to implement the Bill. I think there is a danger in being overly prescriptive and some matters, like a change of culture in the NHS about who can best provide a service is difficult to achieve by statute. Social care services, housing or perhaps a voluntary agency may be better placed to provide a service in partnership with health rather than health alone and would almost certainly be more cost-effective. Lord Warner, Lady Pitkeathley and I have been struggling to find a way to ensure that GPs commission more effectively to produce an integrated service across health and social care at least but we have not really found any way to do it yet which would make sense in legal terms in a bill. We continue to work on this outside the Chamber in the hope we can produce something acceptable at Report Stage.