The new shape of health service commissioning introduced by the Health and Social Care Act is already in place and fully running since 1st April 2013. But the regulations governing commissioning are still the subject of debate. Regulations have already been issued twice by the Government, which maintains that they do no more than codify the existing position. But opponents, including the Royal College of General Practitioners, maintain that the regulations will force every procurement decision made by Clinical Commissiojning Groups to be advertised and go our to format tender, a costly and time-consuming process, which they claim could lead to a rapid shift to private provision of NHS services. The issue will be decided in the House of Lords on 24th April on a motion of Lord (Philip) Hunt, praying against the regulations.