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Ms Jowell: What is important is that clinicians have an overriding responsibility to their patients. We know that one of the undesirable effects of the Government's reforms has been, in many cases, to compromise institutionally their sense of loyalty. This culminated in the remark of one Roy Lilley a year or so ago, that the principal responsibility of clinicians in the NHS was not to their patients, but to their employer. The suggestion that fidelity to the employer has become the overriding obligation is what causes us great concern.
The Minister has no right to sneer at the comparison between the position of independent contractors and that of salaried GPs. GPs acting as independent contractors are perfectly free to raise concerns about the care that their patients receive in hospitals or other parts of the health service, whereas salaried GPs may feel compromised in raising such concerns. That is why we have tabled the new clause.
The Government's failure to support the new clause speaks volumes and will send out a clear message to staff in hospitals and to workers throughout the health service in this country about the Government's indifference to the protection of patients. Fortunately, for reasons that were stated earlier, that indifference will not persist for much longer and a Labour Government will be able to safeguard the interests of staff and patients in the national health service. In view of that, I beg to ask leave to withdraw the motion.
Motion and clause, by leave, withdrawn.
Motion made, and Question put, That the clause be read a Second time:--
The House divided: Ayes 24, Noes 198.
Tellers for the Ayes:
Tellers for the Noes:
Question accordingly negatived.
Mr. Thurnham:
I beg to move amendment No. 1, in page 5, line 7, at end insert--
'.--(1) This section applies to any pilot scheme under which special ophthalmic services are provided.
(2) An agreement which constitutes, or is one of the agreements which together constitute, a pilot scheme may be made by an authority only with one or more of the following--
(a) an NHS trust;
(b) a person on an ophthalmic list;
(c) an NHS employee or a pilot scheme employee;
(d) a qualifying body;
(e) an individual who is providing special ophthalmic services under that or another pilot scheme.
(3) In this section--
"NHS employee" means an individual who, in connection with the provision of services in the health service, is employed by--
(a) an NHS trust;
(b) a medical practitioner whose name is included in a medical list; or
(c) a medical practitioner who is providing personal medical services in accordance with a pilot scheme;
"ophthalmic list" has the same meaning as in section 4A(3) of the National Health Service and Community Care Act 1990 or section 17AA(3) of the 1978 Act;
"pilot scheme employee" means an individual who, in connection with the provision of special ophthalmic in accordance with a pilot scheme is employed by an individual providing those services;
"qualifying body" means a company which is limited by shares all of which are legally and beneficially owned by persons falling within paragraph (a), (b), (c) or (e) of subsection (2).'.--[Mr. Simon Hughes.]
Brought up, and read the First time.
AYES
Ashdown, Rt Hon Paddy
Beggs, Roy
Beith, Rt Hon A J
Bruce, Malcolm (Gordon)
Campbell, Menzies (Fife NE)
Chidgey, David
Dafis, Cynog
Foster, Don (Bath)
Harvey, Nick
Jones, Ieuan Wyn (Ynys Mon)
Jones, Nigel (Cheltenham)
Kennedy, Charles (Ross C & S)
Kirkwood, Archy
Lynne, Ms Liz
Maclennan, Robert
Maddock, Mrs Diana
Rendel, David
Salmond, Alex
Skinner, Dennis
Smyth, Rev Martin (Belfast S)
Steel, Rt Hon Sir David
Taylor, Matthew (Truro)
Wallace, James
Wigley, Dafydd
Mr. Peter Thurnham and
Mr. Simon Hughes.
NOES
Ainsworth, Peter (E Surrey)
Aitken, Rt Hon Jonathan
Alexander, Richard
Alison, Rt Hon Michael (Selby)
Allason, Rupert (Torbay)
Amess, David
Arbuthnot, James
Ashby, David
Aspinwall, Jack
Atkinson, David (Bour'mth E)
Banks, Robert (Harrogate)
Bates, Michael
Batiste, Spencer
Bellingham, Henry
Biffen, Rt Hon John
Body, Sir Richard
Bonsor, Sir Nicholas
Booth, Hartley
Boswell, Tim
Bottomley, Peter (Eltham)
Bottomley, Rt Hon Mrs Virginia
Bowden, Sir Andrew
Bowis, John
Brandreth, Gyles
Brazier, Julian
Bright, Sir Graham
Brooke, Rt Hon Peter
Brown, Michael (Brigg Cl'thorpes)
Browning, Mrs Angela
Burns, Simon
Burt, Alistair
Butler, Peter
Carlisle, John (Luton N)
Carlisle, Sir Kenneth (Linc'n)
Carttiss, Michael
Cash, William
Channon, Rt Hon Paul
Churchill, Mr
Clappison, James
Clark, Dr Michael (Rochf'd)
Coe, Sebastian
Congdon, David
Conway, Derek
Coombs, Anthony (Wyre F)
Coombs, Simon (Swindon)
Cope, Rt Hon Sir John
Couchman, James
Currie, Mrs Edwina
Davis, Rt Hon David (Boothferry)
Devlin, Tim
Dorrell, Rt Hon Stephen
Douglas-Hamilton,
Rt Hon Lord James
Dover, Den
Duncan, Alan
Eggar, Rt Hon Tim
Elletson, Harold
Evans, Nigel (Ribble V)
Evans, Roger (Monmouth)
Faber, David
Fabricant, Michael
Fenner, Dame Peggy
Fishburn, Dudley
Forman, Nigel
Forsyth, Rt Hon Michael (Stirling)
Forth, Rt Hon Eric
Fowler, Rt Hon Sir Norman
Fox, Dr Liam (Woodspring)
Fox, Rt Hon Sir Marcus (Shipley)
French, Douglas
Fry, Sir Peter
Garel-Jones, Rt Hon Tristan
Garnier, Edward
Gill, Christopher
Gillan, Mrs Cheryl
Goodlad, Rt Hon Alastair
Goodson-Wickes, Dr Charles
Greenway, Harry (Ealing N)
Griffiths, Peter (Portsmouth N)
Hague, Rt Hon William
Hamilton, Rt Hon Sir Archibald
Hannam, Sir John
Hargreaves, Andrew
Harris, David
Hawkins, Nick
Hawksley, Warren
Hayes, Jerry
Heathcoat-Amory, Rt Hon David
Hendry, Charles
Higgins, Rt Hon Sir Terence
Hogg, Rt Hon Douglas (Grantham)
Horam, John
Hordern, Rt Hon Sir Peter
Howell, Rt Hon David (Guildf'd)
Howell, Sir Ralph (N Norfolk)
Hughes, Robert G (Harrow W)
Hunt, Sir John (Ravensb'ne)
Hunter, Andrew
Hurd, Rt Hon Douglas
Johnson Smith,
Rt Hon Sir Geoffrey
Kellett-Bowman, Dame Elaine
King, Rt Hon Tom
Kirkhope, Timothy
Knight, Dame Jill (Edgbaston)
Knox, Sir David
Kynoch, George
Lait, Mrs Jacqui
Lawrence, Sir Ivan
Legg, Barry
Lennox-Boyd, Sir Mark
Lidington, David
Lilley, Rt Hon Peter
Lloyd, Rt Hon Sir Peter (Fareham)
Luff, Peter
Lyell, Rt Hon Sir Nicholas
MacKay, Andrew
Maclean, Rt Hon David
McLoughlin, Patrick
Madel, Sir David
Malone, Gerald
Marland, Paul
Marshall, John (Hendon S)
Marshall, Sir Michael (Arundel)
Martin, David (Portsmouth S)
Merchant, Piers
Mitchell, Andrew (Gedling)
Mitchell, Sir David (NW Hants)
Moate, Sir Roger
Monro, Rt Hon Sir Hector
Montgomery, Sir Fergus
Needham, Rt Hon Richard
Neubert, Sir Michael
Newton, Rt Hon Tony
Nicholls, Patrick
Nicholson, David (Taunton)
Norris, Steve
Oppenheim, Phillip
Ottaway, Richard
Page, Richard
Paice, James
Patnick, Sir Irvine
Patten, Rt Hon John
Pattie, Rt Hon Sir Geoffrey
Peacock, Mrs Elizabeth
Pickles, Eric
Porter, David
Powell, William (Corby)
Renton, Rt Hon Tim
Riddick, Graham
Robathan, Andrew
Roberts, Rt Hon Sir Wyn
Robinson, Mark (Somerton)
Rowe, Andrew
Scott, Rt Hon Sir Nicholas
Shaw, Sir Giles (Pudsey)
Shephard, Rt Hon Mrs Gillian
Shepherd, Sir Colin (Heref'd)
Skeet, Sir Trevor
Smith, Tim (Beaconsf'ld)
Speed, Sir Keith
Spencer, Sir Derek
Spicer, Sir Jim (W Dorset)
Spicer, Sir Michael (S Worcs)
Spink, Dr Robert
Spring, Richard
Squire, Robin (Hornchurch)
Stanley, Rt Hon Sir John
Stern, Michael
Stewart, Allan
Streeter, Gary
Sykes, John
Taylor, Ian (Esher)
Temple-Morris, Peter
Thomason, Roy
Thompson, Patrick (Norwich N)
Townsend, Sir Cyril (Bexl'yh'th)
Tracey, Richard
Trend, Michael
Trotter, Neville
Twinn, Dr Ian
Vaughan, Sir Gerard
Viggers, Peter
Waldegrave, Rt Hon William
Walden, George
Waller, Gary
Ward, John
Watts, John
Wells, Bowen
Wheeler, Rt Hon Sir John
Whittingdale, John
Widdecombe, Rt Hon Miss Ann
Wiggin, Sir Jerry
Wilkinson, John
Winterton, Mrs Ann (Congleton)
Winterton, Nicholas (Macclesf'ld)
Wolfson, Mark
Wood, Timothy
Yeo, Tim
Young, Rt Hon Sir George
Mr. Matthew Carrington and
Mr. Roger Knapman.
Amendment made: No. 10, in page 1, line 23, after 'Part I' insert 'or III'.--[Mr. Malone.]
Amendment made: No. 11, in page 4, line 18, leave out from beginning to end of line 24 and insert--
'(2) An authority must prepare and submit such proposals if they are asked to do so by a person--
(a) who wishes to provide piloted services, and
(b) with whom an agreement which constitutes, or is part of, a pilot scheme may be made;
but otherwise they may not do so.'.--[Mr. Malone.]
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