Amendment Paper as at
Tuesday 15th June 1999
CONSIDERATION OF BILL
HEALTH BILL [LORDS], AS AMENDED
Another Clause (NC4) (Criteria for appraisals by the National Institute for Clinical Excellence)—(Dr Evan Harris)—brought up and read the first time, as follows:—
'The Special Health Authority known as the National Institute for Clinical Excellence shall make its appraisals of different treatments and clinical interventions on the basis of clinical efficacy or relative cost-effectiveness compared with alternative treatments or clinical interventions for the same symptoms, but not on the basis of their affordability in relation to the funds available to the National Health Service.'.
Question proposed, That the Clause be read a second time.
NEW CLAUSES
Independent advisory body for public/private partnership schemes in the NHS
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC5
To move the following Clause:—
'The Secretary of State shall establish an independent advisory body to appraise current and future public/private partnership schemes in the NHS.'.
Special Constables
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC6
To move the following Clause:—
'The Secretary of State may establish procedures to allow for joint working arrangements between NHS trusts and local police forces to assist in securing the safety of NHS staff and patients.'.
Independent review of the incidence of discrimination within the NHS
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC7
To move the following Clause:—
'.—(1) The Secretary of State shall appoint an independent review to assess the extent of, and make recommendations to end, discrimination by the NHS on the grounds of age, disability, race, sex and sexual orientation in its capacity as—
(b) a provider of health services.
(2) In subsection (1) "independent" means having a majority of members not employed by the NHS or under the control of the Secretary of State.'.
Health Care and Energy Efficiency Schemes
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC8
To move the following Clause:—
'.—(1) It shall be the duty of every Health Authority and Health Board to prepare, and to consider at least once a year, a report on—
of setting up and funding a health care and efficiency scheme in their area, and every report shall specify those measures that the Authority or Board consider should be taken in order to alleviate fuel poverty in their area.
(2) In subsection (1)—
"fuel poverty" means the inability to afford adequate warmth because of the inadequate energy efficiency of a home;
"health care and efficiency scheme" means a scheme for enabling or assisting persons suffering from fuel poverty to heat their homes more efficiently.'.
Report on current and future human resources in the Health Service
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC9
To move the following Clause:—
'The Secretary of State shall lay before Parliament annually from the year 2000 a report on the numbers, by profession and specialty, of those persons—
(a) training in the NHS; and
and the number of vacancies, by profession and specialty, of those persons in respect of the year to which the report relates.'.
Disclosure of information
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC10
To move the following Clause:—
'The clinical duty to disclose information regarding the current and past treatment of persons under the age of 18 shall be extended, in the case of their death, to those who were legally responsible for them prior to their death.'.
Right to a second opinion on diagnosis or treatment by general practitioners
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC11
To move the following Clause:—
'Each patient of a general practitioner shall have the right to a second opinion on his diagnosis or proposed treatment from a general practitioner in another practice approved by the Health Authority for the area in which the patient resides.'.
Right to a second opinion on hospital treatment
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC12
To move the following Clause:—
'All patients admitted into NHS Trust hospitals shall—
(a) be supplied with the name of the consultant ultimately responsible for their care, and;
(b) have the right to a second opinion if they or their legal guardian raises concerns about the nursing, medical or surgical treatment which they are receiving or which is proposed for them.'.
Health and safety of NHS doctors
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC13
To move the following Clause:—
'In paragraph 6(2) of schedule 2 to the National Health Service and Community Care Act, 1990, after subparagraph (f), there is inserted—
"(g) the duty to implement safe working patterns for all doctors in the training grades, including—
(i) abiding by nationally agreed maximum average hours of duty, minimum periods of rest between duty periods and continuous periods off duty, and
(ii) allowing sufficient time for appropriate training, formal education and study.".'
National Institute for Clinical Excellence (duties and consultation with public)
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC14
To move the following Clause:—
'.—(1) The Special Health Authority known as the National Institute for Clinical Excellence (the "Authority") shall meet in public.
(2) The Authority shall publish annually a report on its activities during the preceding calendar year which the Secretary of State shall lay before Parliament.
(3) The Secretary of State shall establish a public consultative committee in relation to the Authority, which shall have the duty of advising the Authority on the public's view on the priority to be accorded to different treatments and clinical interventions within the NHS.
(4) The constitution and membership of the committee mentioned in subsection (3) shall be such as the Secretary of State may determine in Regulations.'.
Secretary of State to report on and monitor the commissioning of specialised services
Mr Paddy Ashdown
Mr A J. Beith
Mr Simon Hughes
Dr Evan Harris
Mr Paul Burstow
Mr Paul Tyler
NC15
To move the following Clause:—
'.—(1) The Secretary of State shall lay before each House of Parliament annually a general report of his functions relating to the commissioning of specialised services and the monitoring of such arrangements.
(2) In this section, "specialised services" means services which the Secretary of State has identified, through guidance or other means, as services which require to be commissioned by two or more Health Authorities (or Primary Care Trusts), or by the Secretary of State through the National Specialist Commissioning Advisory Group.'.
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—
(iii) associate specialist;
(iv) hospital practitioner;
(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;
(c) appoint a medically qualified doctor to a position described as a specialist without either—
(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.'.
