House of Commons Hansard Debates for 7 Nov 1995

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Madam Speaker's Statement

3.31 pm

Madam Speaker: I have a short statement to make.

The hon. Member for Dover (Mr. Shaw) recently made serious allegations against parliamentary colleagues. He later withdrew the accusation made yesterday against the hon. Member for Barking (Ms Hodge). I asked him to provide written details of his earlier charge against the hon. Member for Hampstead and Highgate (Ms Jackson) and he has now done so. I have studied what he says with care, and I have asked the Serjeant at Arms to look into the aspect that concerns the use of stationery. Whatever the outcome of that inquiry, I do not believe that any of the facts laid before me sustain the charge of corruption in the use of parliamentary facilities.

Free speech is one of this House's most treasured possessions. For that reason, it must be used responsibly and not abused.

The hon. Member for Dover should take careful note of that in future. I would prefer his co-operation in this matter than to be compelled to any more drastic course of action.

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Points of Order

Mr. David Winnick (Walsall, North): On a point of order, Madam Speaker. Some hon. Members have drawn a distinction between statute law as such and complying with resolutions of the House. Are the resolutions passed last night to be implemented and honoured? Is it not the case that, if a resolution of the House is passed, it has all the authority of the House of Commons and there can therefore be no excuse whatever for any hon. Member to argue that, because it is not statute law, it has no bearing on him or her?

Madam Speaker: The hon. Gentleman is asking me hypothetical questions at this stage. It remains to be seen how we begin to implement the resolutions that we accepted last night.

BILLS PRESENTED

Metrication (Removal of Penalties)

Sir Roger Moate presented a Bill to amend the Weights and Measures Act 1985 so as to remove any criminal penalty upon persons using imperial measures unless it is proved that such use was intended for fraudulent purposes: And the same was read the First time; and ordered to be read a Second time tomorrow and to be printed. [Bill 192.]

Family Homes and Domestic Violence (No.2)

Mrs. Diana Maddock, supported by Mr. A. J. Beith, Ms Liz Lynne, Mr. David Rendel, Mr. Archy Kirkwood, Mr. Chris Davies, Mrs. Ray Michie, Mr. Charles Kennedy, Mr. David Chidgey and Mr. James Wallace, presented a Bill to make provision, in relation to cases where a dwelling-house is, has been, or was intended to be, the home of two or more persons, as to their respective rights of occupation; to make provision for preventing the molestation of one person by another; to enable a court to include in certain orders under the Children Act 1989 provision relating to the occupation of a dwelling-house; to make provision for the transfer of tenancies between spouses and persons who have lived together as husband and wife; to apply section 17 of the Married Women's Property Act 1882 to persons who live together as husband and wife; and for connected purposes: And the same was read the First time; and ordered to be read a Second time tomorrow and to be printed. [Bill 193.]

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Patients Rights

3.33 pm

Mrs. Alice Mahon (Halifax): I beg to move,

That leave be given to bring in a Bill to give patients certain rights in their dealings with general practitioners.

My Bill would extend the patients charter to give patients certain rights in their dealings with general practitioners. Those rights would include a requirement for GPs in a practice of four or more, where a doctor-patient relationship has broken down, first, to offer a patient a second chance to stay in that practice by counselling that patient and issuing a warning that that behaviour will not be tolerated in the case of bad behaviour or, secondly, to offer the patient the right to visit another doctor in the same practice. Thirdly, if no other GP in the practice is willing to take the patient, the patients charter should include a requirement that patients be given reasons in writing stating why they are being removed from a GP's list.

This is not a doctor-bashing Bill. I have the greatest respect for our GP service and I recognise the dedication, skill and professionalism of our doctors. However, I believe that there is an injustice against patients and I am sure that, if good will and tolerance were shown by all sides, that injustice might be rectified.

Self-evidently, a good doctor-patient relationship must be based on mutual trust and respect. At present, GPs have the right to request that any patient be removed from their list, and that doctor is under no obligation to say why.

The consequences of such actions can be very far-reaching indeed. For example, if the patient belonged to a large practice, losing his and his family's right to be registered with their nearest GPs might be extremely inconvenient and might involve lengthy travelling, which obviously incurs extra costs.

I have a constituent who was struck off--she believes, for contacting her doctor at 8 o'clock at night to ask him to attend a fairly sick five-year- old. The doctor refused, but the child was admitted to hospital the same evening. The mother and the family were struck off, and now she must travel three miles with her youngest children to the next practice. Her youngest child needs to visit a doctor regularly, and that low-income family has been penalised by a doctor who, I believe, knew that he was wrong not to visit the child and covered his action by striking the whole family off his list. I know that that is not the usual practice, but that family was never told why it had been struck off. Surely a much better outcome would have been for other doctors in the same practice to take on responsibility for that family.

Another consequence of being struck off a doctor's list without being given a reason is the great hurt that is felt by many people when they are.

Another constituent told me that she rarely visited a doctor, but that when she did on one occasion, the receptionist mistook her for someone else and a few words were exchanged. Realising the mistake, my constituent drew attention to it--fairly calmly, she claims--and made an appointment to visit her doctor, only to receive a letter two days later, telling her that she had been struck off. She told me that at first she felt anger

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at the injustice and then she experienced a loss of confidence and a feeling of humiliation. She said that she would be very reluctant to visit a doctor again, however ill she felt.

Another constituent, a very brave 86-year-old, Mrs. Marion Greenwood, a pensioner, was struck off her doctor's list when she was ill. Her daughter, who lives with her, called the GP out when her mother became ill. The GP was angry because it was in the evening and was quite cross with the old lady. Mrs. Greenwood was admitted to hospital a couple of days later in a critical condition. While in hospital, she received a letter from her GP, telling her that she was being struck off and that she should find another doctor. I could go on reciting case after case, but time will not allow.

Obviously, there are instances when GPs have a legitimate right to say, "I personally cannot treat this patient any more." The following reasons were outlined in the advice given by the General Medical Services Committee last year as acceptable reasons for striking patients off a register.

A patient may be struck off if there is violent or threatening behaviour towards a doctor and his family, but even then, the GMSC believes that GPs should use their clinical judgment to determine whether a patient's violent behaviour results from his or her medical condition, and that if the patient is mentally ill, consideration should be given to the condition of that patient.

Other reasons for striking off might be a complete breakdown of the doctor- patient relationship, such as might occur if scurrilous, unfounded allegations were made against a doctor, or prescription fraud or the persistent breaking of appointments, which did not improve after a warning. However, the advice from the GMSC is not firm enough and weighs heavily in the doctor's favour.

There is growing support for my view. The Association of Health Councils in England and Wales is concerned that patients may be removed from lists simply for making a complaint. One woman told me that she was suffering from a back injury and took her son along to the doctor's receptionist. She could not sit down because of her injury. She was told that she might have to wait and the receptionist asked her to sit down. The woman said that she could not and would prefer to stand. Three days later she received a letter striking her off the doctor's list. I saw the letter and the only indication of why she had been struck off was the sentence that stated:

"We hope when you find a new GP there will be comfortable chairs in his waiting room."

That is clearly another exceptional case, but it is unacceptable and exposes the inadequacy of the existing legislation. The woman was struck off the list for something trivial.

There is a growing perception that clients are being removed from GPs' lists because their treatment is too costly. The advent of the internal market and GP fundholding has fuelled that perception. Unfortunately, information on the number of patients being removed from lists at the request of doctors has been available from the Department of Health only since 1992-93. In that year, the total for England was more than 78,000. Those figures do not differentiate between GP fundholders and non- fundholders, so there is no hard and fast evidence.

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However, there is anecdotal evidence that GP fundholders do not want patients whose care is too costly. The Association of Health Councils in England and Wales has expressed concern. Yesterday we learnt that a doctor in Wales intended to strike eight children off his list to increase his practice income by £2,000. Clearly, that has to stop. It is simply not good enough for the Department of Health to talk about unacceptable behaviour. We are entitled to ask what the Department will do about it.

Patients trust doctors less because of the introduction of GP fundholding. They are now, almost daily, made aware of the cost of treatment. Where once a clinical decision was given and accepted, there now lurks a suspicion that a treatment might be advised against owing to the cost. The vital ingredient of trust between patient and doctor is being seriously undermined, which is one reason why it is essential to end GP fundholding.

If implemented, the Bill, which contains moderate measures, could provide the first step towards restoring the trust between patients and their GPs, and I commend it to the House.

3.43 pm

Sir Patrick Cormack (Staffordshire, South): I have considerable sympathy with much of what the hon. Member for Halifax (Mrs. Mahon) has said. I do not wish to call a Division, but I want to raise one valid point.

Our procedure in the House confuses people outside. It is always a pity to excite expectations that one can never fulfil. There is a problem in allowing ten-minute Bills to be introduced within 18 hours of the Prorogation of Parliament. There is no chance of the hon. Lady's Bill, however worthy, passing on to the statute book. It is important for us to put down a marker on the subject.

I hope that the powers that be--the appropriate Committee--will consider whether or not it would be sensible to stop the ten-minute Bill procedure a few weeks before the Prorogation of Parliament, perhaps providing a half- hour Adjournment debate on a Wednesday morning for the purpose. The hon. Lady's speech would have been ideally suited for such a debate.

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I shall not oppose the hon. Lady's leave to bring in her Bill now, but it is a pity that the procedure of the House is allowed to operate in this way.

Question put, pursuant to Standing Order No. 19 (Motions for leave to bring in Bills and nomination of Select Committees at commencement of public business), and agreed to.

Bill ordered to be brought in by Mrs. Alice Mahon, Mrs. Ann Clwyd, Mr. Harry Barnes, Mr. Eddie Loyden, Ms Jean Corston, Mr. Neil Gerrard, Mr. Alan Simpson, Mr. Gerry Sutcliffe, Mrs. Audrey Wise, Mr. John Gunnell, Mr. Dennis Skinner and Mr. Malcolm Chisholm.

Patients Rights

Mrs. Alice Mahon accordingly presented a Bill to give patients certain rights in their dealings with general practitioners: And the same was read the First time; and ordered to be read a Second time tomorrow and to be printed. [Bill 194.]

Mr. Dennis Skinner (Bolsover): On a point of order, Mr. Deputy Speaker. As you know, it is a long-standing convention that an hon. Member who opposes a ten-minute Bill is supposed to follow his voice with his vote. I did not hear anyone shout "No".

What is more, the hon. Member for Staffordshire, South (Sir P. Cormack) said that it would be a good idea to get rid of ten-minute Bills so close to the end of the Session. As you know, Mr. Deputy Speaker, Back Benchers have lost opportunities to speak on various issues on a number of occasions in recent years. The ten-minute Bill provides hon. Members with an ideal opportunity to advance propositions, although they may not become law. I hope that you will not give consideration to the hon. Gentleman's suggestion, or pass it on.

I should also like to know, Mr. Deputy Speaker, your view of an hon. Member who opposes a ten-minute Bill while making it abundantly clear that he has no interest in voting against it.

Mr. Deputy Speaker (Mr. Michael Morris): I refer the hon. Gentleman to page 464 of "Erskine May", on which all will be revealed. It explains that an hon. Member may speak against a ten-minute Bill, but need not voice a "No" when the Question is put.

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Orders of the Day

Criminal Injuries Compensation Bill

Lords amendments considered.

Mr. Deputy Speaker (Mr. Michael Morris): Before I call the Minister, I must make an announcement. Madam Speaker has accepted a manuscript amendment in the name of the right hon. Member for Sedgefield (Mr. Blair), of which copies are available in the Vote Office and the Division Lobbies.

Clause 2

Basis on which compensation is to be calculated

Lords amendment: No. 1, in page 2, line 11, at end insert ("or otherwise determined in accordance with the Scheme") 3.47 pm

The Minister of State, Home Office (Mr. David Maclean): I beg to move, That this House doth agree with the Lords in the said amendment.

Mr. Deputy Speaker (Mr. Michael Morris): With this, it will be convenient to discuss Lords amendment No. 2.

Mr. Maclean: Lords amendment No. 1 makes it clear beyond doubt that the scheme may provide for awards in fatal cases to include, in addition to the fixed-tariff award, additional amounts calculated in accordance with the scheme. That will allow payment to be made for such other elements as reasonable funeral expenses, loss of dependency and loss of parental support. Those elements are not fixed or specified, so provision could not be made for them under subsection (2)(d) as it originally stood. They will be calculated by reference to the circumstances of the case, rather than on the basis of the fixed tariff. The amendment simply ensures that such payments can properly be made.

Let me now deal with Lords amendment No. 2. On introduction, clause 3(1)(c) enabled provision to be included in the scheme in regard to repayment of compensation for breach of conditions subject to which an award was made. However, the scheme also needs to include provision for repayment in other circumstances, such as when the applicant receives compensation from other sources in respect of the same criminal injury, and when that other compensation was not taken into account when the award was made from our scheme. That simply replicates the situation under the present scheme, and is intended to prevent the applicant from receiving compensation twice for the same injury. As originally drafted, the Bill would not have allowed a provision to be included in the scheme providing for such recovery; it accordingly needed to be amended to permit recovery in those wider circumstances.

Mr. Alun Michael (Cardiff, South and Penarth): I am particularly grateful to the Minister for accepting Lords amendment No. 1, which we pursued in the House. It makes the position clear beyond doubt in allowing awards in fatal cases to include funeral expenses and expenses incurred by loss of dependency and loss of parental support.

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Will the Minister clarify the way in which the power conferred by Lords amendment No. 2 will be exercised? I understand the intention of the amendment, which is to ensure that money can be reclaimed. I was hoping that the Minister would answer my question, but I apologise for interrupting the conversation that is taking place on the Government Front Bench.

It is obviously right to deal with cases in which there has been an oversight or a lack of information at the time when an award was made, so that no deduction has been made for the availability of compensation elsewhere; but the provision could also be used in "blanket" ways, and inappropriate amounts could be deducted. Will the Minister therefore clarify how the retrospective power that is given under the amendment will be used in practice? Will the ways in which it is to be used be specified in the scheme, to be published shortly in its final form?

Mr. Maclean: No retrospection is intended. In the present scheme, no one is compensated twice: that is a normal rule of government, the law and insurance law in particular. We never intended that, under the new tariff scheme, someone could receive double compensation. All the amendment does is clarify the law and ensure that the same rule as operated by the Criminal Injuries Compensation Board is carried forward into the tariff scheme. In practice, it will operate in exactly the same way as at present.

No blanket retrospection is applied--I do not know how that could apply. We should bear it in mind that, even moving as quickly as possible, it takes some time to process awards. The board and those operating the tariff scheme will want to receive full information on the means and situation of the victim and on any other income, expenses or money that he acquires. If they find that someone is receiving a full insurance pay-out, or, properly, that the criminal has been ordered to pay compensation to the victim and there is a compensation order against the criminal, so that the victim has received money from the criminal offender, they will reduce the award or not pay it. We are not, however, applying the provision retrospectively to take money back from people who have been properly paid. It merely continues the normal system.

Lords amendment agreed to .

Lords amendment No. 2 agreed to .

Clause 5

Appeals

Lords amendment: No. 3, in page 3, line 42, at end insert ("except so far as the provision relates to functions of persons mentioned in subsection (3)(d)(ii)")

Mr. Maclean: I beg to move, That this House doth agree with the Lords in the said amendment.

Mr. Deputy Speaker: With this, it will be convenient to discuss Lords amendments Nos. 4 and 5.

Mr. Maclean: The first two amendments have the simple aim of ensuring that claims officers or staff appointed by the scheme manager can act as presenting officers at appeals in addition to their more normal job of determining claims.

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As to the third amendment, clause 5(9) was added to the Bill in Standing Committee to make it clear beyond doubt that the scheme may include provision for adjudicators to reduce awards when they consider that an appeal is frivolous or vexatious. That minor, technical amendment to delete the words "under this section" was necessary as appeals are not determined under the Bill, but are determined in accordance with the provisions of the scheme that is to be made under the powers conferred by clause 1. I commend the amendments to the House.

Mr. Michael: I have one query for the Minister, which he may have clarified in his statement. He has been extremely helpful, for which I am grateful to him, in providing information about the intentions of amendments that he expected to come from the Lords. In a letter to me, he refers to the amendments to clause 5, saying that they would allow claims officers to act as presenting officers at appeals in addition to their main role in determining appeals. That leads to confusion, but it may simply be a misprint--their main role is in determining claims rather than appeals. If that is the case, I am happy to support the Minister in seeking to pass the amendment.

Mr. Maclean: It certainly sounds like a misprint. Claims officers determine claims, not appeals and they may then present the information to the appeals panel, which will determine the appeal. Lords amendment agreed to .

Lords amendments Nos. 4 and 5 agreed to .

Clause 8

Annuities

Lords amendment: No. 6, in page 6, line 11, at end insert-- ("(3) In this section "the Criminal Injuries Compensation Scheme" means--

(a) the scheme established by arrangements made under the Criminal Injuries Compensation Act 1995; or

(b) arrangements made by the Secretary of State for compensation for criminal injuries and in operation at any time before the commencement of that scheme.")

Mr. Maclean: I beg to move, That this House doth agree with the Lords in the said amendment.

Mr. Deputy Speaker: I must inform the House that this amendment involves privilege.

Mr. Maclean: The amendment fulfils a promise made in the Standing Committee to extend the benefits of structured settlements so that they are available under the new tariff scheme to applicants under the current common law damages scheme or any other previous version of it, whose claims have not yet been settled. The necessary complementary amendment to the 1990 scheme to permit payment of compensation by the purchase of annuities will, as we also promised, be made administratively as soon as the Bill receives Royal Assent. This is an excellent amendment, which I commend to the House.

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Mr. Michael: We support the objective of the amendment. The Minister says that people whose claims have not been dealt with will have the opportunity of structured settlements and the tax arrangements that are allowed for under the Bill. What will the cut-off date be? Will the ability to deal with claims by structured settlement date from the time when the Bill began its passage through the House and the declaration of the Government's intentions, from the date on which Royal Assent is signified or from a future date when the Government or Home Secretary implement that aspect of the Bill? I am sure that the Minister will agree that it is important to be clear on those points. I hope that he will give the earliest possible date, so that the advantages of the new scheme will have the widest possible application.

On the Order Paper today there is a written question tabled by the hon. Member for Welwyn Hatfield (Mr. Evans), who sometimes asks questions that are regarded as convenient to Ministers. The hon. Gentleman asks whether structured settlements will be offered under the current criminal injuries compensation scheme. If any new information is to be provided to the hon. Gentleman, will the Minister share that information with us?

I ask that question because it is quite common for members of the press to have information about written parliamentary answers long before hon. Members. I am sure that the Minister will agree that it would be courteous to give the House as much information as possible in view of the fact that that question--coincidentally, I am sure--has been tabled on the day of this debate.

Mr. Maclean: I am not aware that I have any extra information to present to the House. I was not aware that my hon. Friend the Member for Welwyn Hatfield (Mr. Evans) had coincidentally decided to ask a question, which might correspond with an urgent need that I had to present information. I shall be advised on it and I hope that I shall be able to confirm whether that is the case. We intend to have structured settlements. We think that they are a good idea. If any new information needs to be presented, I shall do so.

Mr. Michael: As I understand it, the Minister is answering that written question today, so if I speak slowly, any additional information might wend its way to him. If there is no additional information that is not already available to the House, I would be happy if, at this late stage in the Bill's proceedings, the Minister could confirm that.

Mr. Maclean: I have no extra information to provide, and nothing new to say on it. I can only conclude that my hon. Friend the Member for Welwyn Hatfield was not fully aware of all the information that we had issued previously when he decided to ask for an update. The update will provide the same information.

The earliest date of implementation will be Royal Assent. This part of the legislation cannot be retrospective because that would create tremendous anomalies. The question might arise whether, in some cases, the generous settlements that we are making under some aspects of the tariff award should not also be made retrospective. That would be very unfair. We expect the benefits of structured settlements to take effect when the Bill receives Royal Assent.

Lords amendment agreed to [Special Entry].

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New clause

Jurisdiction of Parliamentary Commissioner for Administration

Lords amendment: No. 7, after clause 9, to insert the following new clause--

".--(1) In the Parliamentary Commissioner Act 1967, insert after section 11A--

"The Criminal Injuries Compensation Scheme.

11B.--(1) For the purposes of this Act, administrative functions exercisable by an administrator of the Criminal Injuries Compensation Scheme ("Scheme functions") shall be taken to be administrative functions of a government department to which this Act applies. (2) For the purposes of this section, the following are administrators of the Scheme--

(a) a claims officer appointed under section 3(4)(b) of the Criminal Injuries Compensation Act 1995;

(b) a person appointed under section 5(3)(c) of that Act; (c) the Scheme manager, as defined by section 1(4) of that Act, and any person assigned by him to exercise functions in relation to the Scheme.

(3) The principal officer in relation to any complaint made in respect of any action taken in respect of Scheme functions is-- (a) in the case of action taken by a claims officer, such person as may from time to time be designated by the Secretary of State for the purposes of this paragraph;

(b) in the case of action taken by a person appointed under section 5(3)(c) of the Act of 1995, the chairman appointed by the Secretary of State under section 5(3)(b) of that Act; or

(c) in the case of action taken by the Scheme manager or by any other person mentioned in subsection (2)(c) of this section, the Scheme manager.

(4) The conduct of an investigation under this Act in respect of any action taken in respect of Scheme functions shall not affect-- (a) any action so taken; or

(b) any power or duty of any person to take further action with respect to any matters subject to investigation."

(2) In Schedule 3 to the Act of 1967 (matters not subject to investigation), insert after paragraph 6B--

"6C. Action taken by any person appointed under section 5(3)(c) of the Criminal Injuries Compensation Act 1995, so far as that action is taken at the direction, or on the authority (whether express or implied), of any person acting in his capacity as an adjudicator appointed under section 5 of that Act to determine appeals." (3) The amendments made by this section do not affect the following provisions of this Act--

(a) section 3(5)(b);

(b) section 3(7)(b);

Mr. Maclean: I beg to move, That this House doth agree with the Lords in the said amendment.

The amendment fulfils undertakings given during earlier Commons stages that we would bring the administrative actions of the administrators of the scheme and those supporting the independent appeals system within the jurisdiction of the parliamentary ombudsman. Although the amendment appears to be long and complicated, it is a simple measure to ensure that the administrative aspects of the new system come within the ken and purview of the ombudsman.

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