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Mr. McLeish: No one would disagree with the logic of the Minister's contribution. The central point is the fact that we have structures, institutions, guidance and processes. That is not the issue. I do not say that we necessarily want a heavy hand directing from the centre, but what we have heard has made it clear that there are excesses in the system. Perhaps the cases that have been
mentioned are profoundly complex and take masses of time to resolve. None the less, it would be instructive for the Government and for us if we could find out what is happening throughout the country, so that any further consideration by the Minister could be informed by what was happening in the trusts. This is not a case of the trusts ignoring the guidelines, but it is clear that the application of them may differ from one trust to another. That may be healthy in some respects, but we need consistency and fairness, and that consistency would be better informed if we knew what was happening throughout the country.
Mr. Malone: The system gives me that information, should there be undue delay. I have explained to the House that, if there is undue delay in resolving a suspension and turning it into either a full inquiry or a dismissal of the complaint, the information is gathered after six months. When evidence was given to the Public Accounts Committee, six such cases were outstanding. Considering that more than 17,000 consultants are employed by the NHS, that is a small number.
When such a delay has been brought to our attention, of course inquiries are made about whether it is reasonable; we fully expect people to comply with the guidelines. The guidance is not simply thrown out into the blue yonder, with Ministers washing their hands of it and saying, "We have written the guidance, and that is all we intend to do." It is important to us that there is general compliance. However, I reiterate the fact that we expect employers to build on the guidance in a manner appropriate to their local circumstances.
It is important that all procedures are clear and flexible and ensure that patients' interests are protected, that fair treatment is provided for practitioners, that cases are dealt with as speedily as possible, and that professional advice is taken in appropriate circumstances in individual cases. Those are the principles on which the guidance is based.
My hon. Friend the Member for Edgbaston raised several specific points, with which I shall now deal. First, she said that suspension was sometimes used for trivial reasons. The guidance clearly implies that suspension is a serious matter and should not take place for a trivial reason. However, what is a trivial reason in the eyes of one party may be an important reason in the eyes of another. I can certainly give my hon. Friend the assurance that I would not expect trivial reasons to lead to suspension. I would expect employers to consider all such issues carefully, as the guidance requires them to, before taking the important step of suspension.
My hon. Friend also talked about the process not affecting the right to practise. It does not. The hon. Member for Southwark and Bermondsey (Mr. Hughes) rightly said that there are other ways in which the right to practise can be handled--through the General Medical Council.
Perhaps it would be helpful to my hon. Friend if I were to clarify the position. Suspension is a neutral act, so if a practitioner under suspension decided to resolve the matter himself or herself by simply moving out of the context of that employment and getting another job, that would be entirely possible. Nothing would have been proven against the practitioner, and it would be wrong to prejudge the issue by saying that the right to practise should be diminished by the act of suspension.
Dame Elaine Kellett-Bowman:
Should not the fact that the practitioner is under suspension be disclosed to the hospital to which he applies?
Mr. Malone:
Suspension is a neutral act. My hon. Friend is suggesting that suspension should be seen as something other than a neutral act.
The House has put legislation on the statute book which allows immediate referral to the GMC if the suspension involves a serious matter of basic professional competence, and that is the correct route in such cases. That is a decision for the individuals involved. We must not forget--I am sure that my hon. Friend the Member for Edgbaston does not forget--that a reference to the GMC can be made by someone other than the employing body; it could be made by a fellow practitioner. There is a range of ways in which to handle that aspect of the ability to carry out medical practice, apart from the act of suspension.
This has been an important debate. I thank my hon. Friend for giving me the opportunity to address some of her concerns directly and to explain the position on suspensions and investigations. I hope that I have also given the House an assurance that the Government take the matter extremely seriously. I hope that my hon. Friend will bring the individual cases that she has raised to my attention. I shall be happy to consider them, and I have said that I shall consider her request for a meeting with those who have raised them with her.
Mr. Edward O'Hara (Knowsley, South):
When the Fresh Meat (Hygiene and Inspection) Regulations (1995) were laid before the House in March 1995, I tabled early-day motion 845, in which I posed certain serious questions about the rationale, proposed operation and likely effectiveness of the Meat Hygiene Service. The early-day motion attracted considerable support from a remarkable spectrum of interests across the House, an indication not only of the strength of the case but of the far-reaching implications of the new arrangements for abattoirs and jobs across the country.
Following a prayer against the proposed regulations, they were presented for the scrutiny of the Fifth Standing Committee on Statutory Instruments on 4 April 1995. A devastating case against the regulations and the introduction of the MHS was developed in that Committee with the support of the hon. Members for Clwyd, South-West (Mr. Jones), for Manchester, Central (Mr. Litherland), for Carmarthen (Mr. Williams), for North Cornwall (Mr. Tyler), for Aberdeen, North(Mr. Hughes) and for Ceredigion and Pembroke, North(Mr. Dafis)--an interesting cross-section of Members.
The rationale offered for the establishment of the MHS had three legs--greater cost-effectiveness, greater efficiency and greater consistency in relation to the existing system managed by local authorities. In Committee, it was clearly demonstrated that the MHS would not satisfy any of these criteria.
In terms of cost-effectiveness, the MHS has an establishment that costs about £54 million to run. All these costs must be taken out of the industry in charges. I have heard varying figures for the cost to the industry in charges to local authorities under the old system, ranging from £26 million to £45 million. Whichever figure we take, there is a sudden and serious increase in overheads to be financed by the industry.
I shall not burden the House with excessive repetition of the case made in Committee, as the non-validity of the claims of greater efficiency and greater consistency will be exposed in my remarks today. Suffice it to say that, I made no apology then for stating that there was a crisis in the fresh meat industry in two respects.
First, small and medium-sized operators, such as Sammy Morphet of C.S. Morphet and Co. in my constituency, were predicting that they would be driven out of business by the increased charges. Indeed, in my early-day motion, I asked whether the new system was actually intended as an instrument for enforced rationalisation in the industry. This was a serious question, as to whether we were witnessing rationalisation by statute, rather than by inducement and compensation.
An important aspect of the crisis in the industry was the breach between the hierarchy of the Federation of Fresh Meat Wholesalers--the consultative body for the industry favoured by the Ministry of Agriculture, Fisheries and Food--and people such as Sammy Morphet of Cronton in Knowsley, Thomas Slinger of Greater Harwood near Blackburn, E.D. Jones and Son of St. Asaph, Cig Mon Cymru--I hope that the hon. Member for Ynys Mon (Mr. Jones) will forgive my
pronunciation--from Llangefni in Anglesey and Keighley Abattoir Ltd. Mr. Whitely, from the last company mentioned, said in a letter that was passed to me in April,
Many others have been involved, including Toby Baker of Nailsea. I mention him in particular because he is the secretary of the Quality Meat and Livestock Alliance, to which many disillusioned small and medium-sized operators have turned to represent their interests.
Secondly, many endangered operators are determined not to pay the increased charges with which they are faced under the new system. It is a classic case of "can't pay, won't pay". I have kept in touch with the situation since the introduction of the Fresh Meat (Hygiene and Inspection) Regulations 1995 and the inception of the MHS, and I take no pleasure today in saying, "I told you so". All the predictions have come to pass, and a report in the Daily Mail this week stated that 120 companies are refusing to pay their fees to the MHS, which is facing a shortfall of £14 million in its annual budget.
"For God's sake make them understand what is going on".
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