Vote Bundle Text (990610-02)

Amendments proposed to the Health Bill [Lords], As Amended - continued	House of Commons

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Protection of doctors' clinical freedom to prescribe appropriate drugs

Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler

NC16

To move the following Clause:—

'.—The Secretary of State shall not exercise his powers to include a drug in schedule 11 to the National Health Service (General Medical Services) Regulations 1992 (as subsequently amended) in such a way as to restrict the circumstances in which the drug may be prescribed by reference to the different underlying causes of the symptoms for whose treatment it is clinically effective.'.

Cost or affordability not to be criteria for restricting prescribing of drugs

Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler

NC17

To move the following Clause:—

'.—In issuing guidance on prescribing, or in exercising his powers to include a drug in schedule 10 (drugs and other substances not to be prescribed for supply under pharmaceutical services) or schedule 11 (drugs to be prescribed under pharmaceutical services only in certain circumstances) to the National Health Service (General Medical Services) Regulations 1992 (as subsequently amended), the Secretary of State shall not base his decision on the criterion of either the cost or the affordability of the drug in question.'.

Restriction on power of NHS Trusts to make appointments

Mr Paddy Ashdown
Mr A. J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler

NC19

*To move the following Clause:—

'(1) NHS Trusts may not—

(a) advertise for, or seek to employ doctors in, clinical non-academic posts other than posts described as—

(i) consultant;

(ii) staff grade;

(iii) associate specialist;

(iv) hospital practitioner;

(v) clinical assistant;

(vi) pre-registration house officer;

(vii) senior house officer;

(viii) specialist registrar;

(b) advertise for, or seek to employ junior doctors in, the following posts—

(i) pre-registration house officer;

(ii) senior house officer;

(iii) specialist registrar;

unless those posts have valid educational approval and staffing approval;

(i) the individual holding a Certificate of Completion of Specialist Training, or;

(ii) the individual being included in the specialist register;

unless the appointment is an approved appointment to a post of associate specialist.

(2) In subsection (1)(b)—

"educational approval" means the approval of the appropriate Royal College, or (for pre-registration house officers) the appropriate university.

"staffing approval" means the approval of the appropriate post-graduate dean.'.

Relaxation of duty of clinical confidentiality in respect of patients under 18

Mr Paddy Ashdown
Mr A. J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler

NC20

*To move the following Clause:—

'The duty of clinical confidentiality in relation to patients under the age of 18 shall not prevent the disclosure in the case of the death of such a patient, of records, whether in documentary form or otherwise, relating to his treatment, to any person legally responsible for the deceased patient prior to his death.'.

Waiting times

Mr William Hague

Mr Peter Lilley

Mr James Arbuthnot

Miss Ann Widdecombe

Mr Alan Duncan

Mr Philip Hammond

NC21

*To move the following Clause:—

'( )—(1) The Secretary of State shall, by 31st March 2000, put in place such systems and procedures as he thinks fit for the monitoring, collection, and publication of—

(a) mean waiting times for first outpatient appointments, by major specialty,

(b) mean waiting times for admission to NHS hospitals, by major specialty.

(2) The Secretary of State shall be responsible for ensuring that publication under subsection (1) be made at least four times annually.

(3) The Secretary of State shall set and publish performance targets in relation to the average waiting times mentioned in subsection (1) above.'.

Independent hospitals

Mr William Hague

Mr Peter Lilley

Mr James Arbuthnot

Miss Ann Widdecombe

Mr Alan Duncan

Mr Philip Hammond

NC22

*To move the following Clause:—

'( )—(1) The Secretary of State may by regulations—

(a) extend the duty in section 18,

(b) extend any or all of the functions of the Commission for Health Improvement as he sees fit, and

(c) Specify additional functions for the Commission for Health Improvements to be extended for the purposes of accreditation and further regulation to any independent hospital.

(2) In this section "independent hospital" means premises—

(a) within the meaning of "hospital" given by section 128(1) of the 1977 Act;

(b) which are not a health service hospital within the meaning of the 1977 Act nor any other premises maintained or controlled by a government department or local authority or any other authority or body instituted by special Act of Parliament or incorporated by Royal Charter; and

but excludes—

(i) any premises used, or intended to be used solely or predominantly, for the reception of and the provision of nursing for persons suffering from any sickness, injury or infirmity;

(ii) any sanatorium provided at a school or educational establishment and used, or intended to be used, solely by persons in attendance at, or members of the staff of, that school or establishment or members of their familities;

(iii) any first aid or treatment room provided at factory premises, at premises to which the Officers Shops and Railway Premises Act 1963 applies or at a sports ground, show ground, or place of public entertainment;

(iv) any premises used, or intended to be used, wholly or predominantly—

(a) by a medical practiioner for the purpose of consultations with his patients;

(b) by a dental practitioner or chiropodist for the purpose of treating his patients, or

unless they are used or intended to be used for the provision of treatment by specially controlled techniques as defined in section 21 of the Registered Homes Act 1984 and any regulations made thereunder,

(v) any premises used, or intended to be used, wholly or mainly as a private dwelling; or

(vi) any other premises excepted from the definition of a "nursing home" for the purposes of section 21 of the Registered Homes Act 1984 by regulations made thereunder by the Secretary of State.'.

Leave to withdraw from Primary Care Trust

Mr William Hague

Mr Peter Lilley

Mr James Arbuthnot

Miss Ann Widdecombe

Mr Alan Duncan

Mr Philip Hammond

NC23

*To move the following Clause:—

'(1) The Secretary of State may, by Order—

(a) grant any individual provider of general medical services leave to withdraw from any established Primary Care Trust;

(b) grant any indivdual provider of general medical services leave to withdraw from the direct budgetary control of a Health Authority, or sub-commitee thereof.

(2) Any provider of general medical services given leave under subsection (1) above shall take on such powers, functions, and budget as may be prescribed by the Secretary of State.'.

Duty to publish report on healthcare expenditure

NC24

*To mote the following Clause:—

'The Secretary of State and the Chancellor of the Exchequer shall publish each year in respect of the preceding financial year—

(1) the percentage of United Kingdom gross domestic product spent on the NHS;

(2) the percentage of United Kingdom gross domestic product spent on all healthcare; and

(3) a target percentage of gross domestic product for expenditure on all healthcare in the United Kingdom.'.

Duty of Secretary of State to provide partnership with private sector

NC25

*To move the following Clause:—

'(1) It shall be the duty of the Secretary of State to promote partnership between the NHS and the private and voluntary sectors with the objective of securing an aggregate level of resources for the delivery of healthcare in the United Kingdom such that the maximum possible percentage of total demand for clinically appropriate treatment is met.

(2) The Secretary of State shall publish in respect of each financial year an estimate of the additional financial and human resources which the NHS would have required during that financial year to meet all demands for health care which were clinically appropriate.'.

Duty to publish reports on standard of heath care in different parts of United Kingdom

Mr William Hague
Mr Peter Lilley
Mr James Arbuthnot
Miss Ann Widdecombe
Mr Alan Duncan
Mr Philip Hammond

NC 26

*To move the following Clause:—

'(1) The Secretary of State shall establish an independent body the duty of which shall be to monitor the provision of health services in England and Wales and in Scotland and to report annually to him on differences between the level of health service provision in Scotland and England and Wales.

(2) The Secretary of State shall cause each such report received to be published.'.