In the above context, in our view, it is wrong to suppose that because the internal market is being abolished there is no longer a commissioning role. Commissioning is a means of ensuring that agreed plans are put into action. The new LHB, incorporating as it will service provider functions, will be much better placed than the District Health Teams themselves to ensure plans are translated into practice in the secondary (and other more specialist) care services.
In our view, the smaller local LHBs now to be abolished were far too small and lacked the expertise to cope with planning and commissioning functions, especially when they had little influence over the major service providers. The structure now proposed will help to rectify that weakness, but the one strength of the small (old) LHBs - their ability to relate to local communities and identify their real needs - should not be lost in the restructuring process.
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