Thank you for contacting me about Clause 119 of the Care Bill. I've done some fairly detailed research into the issue and, I'm happy to say, it turns out there's a great deal more to the argument than it first appears. The crucial question is what should happen when a hospital goes so badly wrong that it starts to let down its patients, as happened in the dreadful scandal of awful care in Mid Staffordshire Hospital for example. Goodness knows I'm not usually a fan of the last Labour Government but, in this case, they (rightly) set up the Trust Special Administrator process, so they could put a 'hit squad' of top managers into any NHS hospital if it was going off the rails. That's fine as far as it goes, but if the new managers of the failing hospital decide they have to close down a particular service (e.g. hip replacements) because it isn't safe for patients to carry on, it's got to be provided by another hospital nearby. Otherwise parts of the NHS service would close without being replaced, leaving patients in the lurch.
So the NHS has to be able to make sure that any service which is closed in a failing hospital is moved to a good one, rather than simply abandoned altogether. That means neighbouring trusts will have to expand their services to match, and normally the local GPs and other medical professionals in the area would simply discuss and agree on the medically-best and most cost-efficient way of doing this. But, very occasionally, they may not be able to reach an agreement and, since it clearly wouldn't be fair to leave patients without the missing services just because local medics can't agree on a decision, the new clause allows the Secretary of State to break the deadlock and make a decision so services aren't lost.
As you'll appreciate, it's a pretty unlikely that local medical professionals won't be able to agree on the best answer, so this is purely a 'last resort' power for when everything else has been tried unsuccessfully. But, I'm sure you'd agree, doing nothing would put patients' health at risk by expecting them to put up with underperforming or missing services.
Interestingly, once all these points had been explained in the Parliamentary debate on Clause 119, Paul Burstow (the MP who tabled the amendment which everyone was campaigning about) was persuaded that it's the right thing to do, and urged everyone to support the clause after all. As a result, the only people who still opposed it were the ones with a party-political axe to grind; Ed Miliband and the Labour Party, the trade unions (particularly Unite) and left-leaning pressure groups like '38 degrees'. Everybody else in the 'sensible centre ground', as I call it, was greatly reassured.
Yours sincerely,