We have had a full debate both on Report and in Committee. As my hon. Friends have made clear, in many respects we support the Bill, but, having completed its consideration in Committee and on Report, there are still aspects of the Bill that leave with us grave concern.

We believe that the Bill still creates the possibility for commercialisation of primary care—the presence, as the British Medical Association put it, of the third party in the consulting room, compromising the overriding responsibility of general practitioners to their patients, regardless of other considerations. We believe that the Bill still represents a leap in the dark. We do not know how many pilots are likely to develop as a result of the Bill. As it stands, they will be unevaluated, without systematic parliamentary scrutiny through regular annual reports, and without adequate local consultation with local medical committees.

We believe that the strategic role of the medical practices committee has been compromised and we are not satisfied that there are adequate safeguards for patients. There remains the possibility of GPs and staff employed by pilots being gagged and losing their present freedom to speak up for patients when they are concerned about aspects of their clinical care.

At the beginning of the Committee stage, we were promised not only that we would hear the Government's case put by the Minister, which it certainly was, but that Conservative Members would speak up at relevant points in Committee and on Report. However, apart from the odd intervention and some sedentary interventions, they remained silent. It was a case of Malone alone.

We hope that the Bill's provisions will be implemented by a Labour Government, who will replace the drive to commercialise with a drive to restore the national health service and primary care as a public service. We want to put the fragments of the national health service back together again, and consequently end the lottery that has been created by the internal market. We want a national health service that provides proper protection for patients and for staff by ending the gagging that has again been imposed by trusts which are competing under the internal market.

Perhaps most of all, we want an opportunity to restore fairness between patients. Primary care is an essential part of the service that all of us most often use as patients. We are usually not patients in hospital but patients of our general practitioner or of another part of the primary care system. The overriding obligation within that context is to establish fairness between patients, which is the essence of our argument against fundholding. The fundholding system has deliberately been established, not to treat patients on the basis of their clinical need, but to allow patients access to treatment on the basis of their GP's status. We do not think that that is acceptable, because it drives at the very heart of the NHS's purpose.

The Government cannot understand that message, which is why the NHS will be at the centre of a general election campaign that Opposition Members believe will result in the Government being driven from office, and not a moment too soon.