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Mr. Eric Martlew (Carlisle): Perhaps the right hon. Lady will explain to the House why she voted for the legislation in 1988.

Miss Widdecombe: We did not add the measure to the cumulative effect of a series of taxes that penalise one group of people who may use the NHS. That is exactly what the Government are doing. If the hon. Gentleman had listened--he usually does--he would have found that, right at the beginning, I said that we might have had some sympathy for the Bill but for the cumulative effect on motorists.

Ms Julia Drown (South Swindon): Will the right hon. Lady give way?

Miss Widdecombe: No, I have just given way on that point. I now want to make some progress.

I was about to say, before I was interrupted, that I was grateful to the Secretary of State for one thing--the assurance that the new charges would not be levied retrospectively. I am glad that he has said that. I take it from what he has said that, even though the hospitals could have collected the money under the 1988 powers and too often did not, there is no suggestion that that should now be recovered. I am sure that that will be welcome both to the insurance companies and to motorists.

Will the Secretary of State accept that the measure is proof positive that we ration health care services in the NHS, and that there is only a limited amount that can be done? After all, the Government have boasted, with their quaint method of accounting, that they have put £21 billion extra into the NHS, yet they still find it necessary to fine motorists £10 for the crime of needing hospital treatment. Does that not say it all? Is it not true that the National Institute for Clinical Excellence will ration treatment and services throughout our health care system?

I wonder how comfortable the Minister of State feels today. He described the Road Traffic Act 1988 as a sick law. He has tried to get out of that since then by saying that he was referring to the 1930s regulations, but his

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comments were made in 1995, when the issue of the day was an order that simply increased the scale of charges for the liability incurred. So what was he then complaining about? Was he complaining that a little more money was being collected from insurance companies? So today he decides to collect a vast amount more. He described the 1988 Act as a tax on accidents, and today he seeks to increase that very tax.

The Minister of State, Department of Health (Mr. Alan Milburn): We have heard this tired old record from the right hon. Lady before. Unfortunately, it does not quite fit with the facts.

My concerns in 1994 arose from a case in which two of my constituents faced an emergency treatment fee following an accident involving their three or four-year-old daughter. I thought that the emergency treatment fee was wrong in principle, as it was levied by the hospital. I argued then that it should be abolished. I am pleased that the Government are abolishing it now. I know that the right hon. Lady is intent on torturing the facts until they confess, but she might spend a little time explaining why her Government promised to abolish the emergency treatment fee, and then failed to deliver on that promise.

Miss Widdecombe: The right hon. Gentleman refers explicitly to a tax on accidents. There is not much other description that one can give to the charges that the Government are now extending than a tax on accidents. That is what he condemned, and what he is now promoting.

On the emergency fee, let me again give some comfort to the Secretary of State, and say that we welcome that measure. We shall not seek to oppose it. We said that, when a suitable legislative vehicle, arose we would use it to abolish the fee.

Mr. Milburn: Will the right hon. Lady give way?

Miss Widdecombe: No. I have given way to the Minister on this point.

The Secretary of State has consistently said, "No new charges," but now he proposes just that. So much for Labour's sacrosanct principle of an NHS free at the point of consumption.

Lastly, I am somewhat concerned--I am open to conviction on this--that the mechanisms that are being put in place will be expensive and bureaucratic. Those who are responsible for collecting moneys have claimed that the problem is not so much the method of collection as the fact that the sums involved for individual trusts are so small compared to the bureaucracy of claiming them in the first place that there has been no incentive to claim. In what way do the proposed methods represent increased simplicity over the old methods?

We have some sympathy with the measure--[Hon. Members: "Then show it."] We are pressing our amendment to a vote. We have some sympathy with the measure, but I am concerned by the cumulative effect on motorists.

Mr. Dobson: So why does the amendment state:

Miss Widdecombe: That is how a reasoned amendment is phrased. The right hon. Gentleman has

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been in the House all these years, but appears not to know that--he learns something new every day, does he not? If the Bill receives Second Reading, we shall examine in detail in Committee some of the points that I have raised today.

The Bill would result in a most unfortunate additional imposition on motorists, at a time when substantial impositions have already been levied. If the measure stood alone, it might not be so significant. The Labour Government generally seek to bash the motorist, and the frivolity with which Labour Members have treated the subject lends credence to our belief that they do not take such matters seriously.

I hope that the Minister will be able to reassure us on uninsured drivers. Why should law-abiding motorists pay twice? Why are they, uniquely, being picked on? I have no complaint about the fact that the Secretary of State is, quite properly, reviewing the collection of the charges, but why has he not reviewed the groups from whom the charges are collected? Why does he not perceive the obvious illogicality in picking on only one group of people, who use the national health service at a time when they are extremely vulnerable--in an emergency, when they are often badly injured, ill and in need of major treatment? Surely that is not the group that should be singled out for progressive taxation.

Mr. Dobson: Will the right hon. Lady give way?

Miss Widdecombe: I was about to finish, but I shall give way.

Mr. Dobson: The arguments that the right hon. Lady has adduced over the past few minutes suggest that she believes that the charge should be repealed entirely. It has been in existence since 1930; it was reconfirmed and extended in 1933; and it was last reaffirmed by the House in 1988, under the Conservative Administration of which she was a member. All we are doing is ensuring that, in future, insurers will pay the money that they should pay.

Miss Widdecombe: All the right hon. Gentleman is doing is putting an extra charge on the motorists. [Hon. Members: "No, he is not."] Yes, he is: he is saying that he will raise a great deal of extra money through the proposed collection method. He is fond of referring to events that occurred under the Conservative Government, so let me point out that, when we introduced more efficient collection procedures to raise money from existing taxes, the then Labour Opposition counted that as a tax rise. Now they are getting a dose of their own medicine.

The Secretary of State is levying an extra charge on motorists, at a time when substantial charges have already been levied. The Bill is not the most sensible of measures, but I hope that it can be improved in Committee, and that the right hon. Gentleman will stop laughing at the plight of the law-abiding motorist, who will have to pay twice for the rest.

4.53 pm

Mr. Eric Martlew (Carlisle): To listen to theright hon. Member for Maidstone and The Weald (Miss Widdecombe), one would think that there was a

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charge on the patient, but there is no charge whatsoever on the patient. The idea that the Government will take money from vulnerable people is nonsense. What they will do is take money from the insurance companies that should have been paying it in the first place. The fact is that fewer bills will be sent out after the Bill is passed, because the Government are getting rid of the emergency charge. That is the charge that causes aggravation and distress to people who are asked for the money when they are in casualty, or who get a letter in the post. The Conservative never achieved the objective of getting rid of that charge, but the Labour Government are doing it.

I congratulate my right hon. Friend the Secretary of State on having found a slot in the legislative programme for the Bill. I am disappointed that it is to be opposed and will therefore take more time. If the Opposition, both here and in another place, were more co-operative, we could get through more legislation, but that is obviously not going to happen.

On 22 July, I asked the Secretary of State about this matter and he said that it was wrong for the insurance companies not to pay. His Department had calculated the figure at £50 million, but the Automobile Association estimated that it was £440 million. The correct amount of money will now be paid to the national health service.

The legislation will not affect all those who are injured in road accidents; it will affect only the innocent victims. For example, if I fall asleep behind the wheel, have an accident and I am treated in hospital, I obviously will not be able to claim against anyone else's insurance. In the absence of any claim, the NHS will continue to treat me for free. However, if there were a passenger in the car, he or she could claim against my insurance. The NHS will still bear the vast cost of treating road accident victims.

The charge was first drawn to my attention as a Member of Parliament when I took up the case of a constituent who had received an emergency bill. I was told that the legislation had been on the statute book for decades and that my constituent simply had to send the money to the insurance company. The bill would then be paid and there would be no problem with the no-claims bonus. Initially, it seemed to be a good way of raising money for the NHS. However, the emergency fees have caused problems, and I am glad that the Government have decided not to pursue the issue and to abolish those charges.

I have examined the real terms cost to hospitals and the amounts that they receive in compensation. In one year, my local hospital received back about £80,000 after treating 1,000 patients. I pressed my local hospital about the matter--there was a Conservative Government and the trust budget was facing a shortfall--and it managed to raise more than £100,000. However, that is not a great deal of money when viewed in the context of 1,000 road accidents.

I am pleased that the money will now go to the hospitals that treat the patients. That is a great advantage for areas such as Cumbria, where we have a sparse population but many tourists. This measure is better for rural areas as it is not fair to put the money into a general pool. My local hospital will benefit considerably. Many visitors to Cumbria--probably too many--travel by car and there is a considerable number of road accidents each year. The hospital received £100,000 last year, but the treatment of one overseas tourist in the Cumberland

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infirmary cost £45,000. That puts the matter in context. In that case, the German insurance company paid the bill and there was no problem.

Although we expect this legislation to raise considerable extra money for the NHS, the reality is that the health service will never have enough money. Cumbria has done very well under this Government: we are to have a new district general hospital and there is a health action zone in the north of the county. However, my constituents realise that resources will always be scarce and it is wrong to claim that this legislation is unpopular with the general public. The Conservatives and the Liberal Democrats have picked the wrong approach--the Liberals always do.

My local newspaper, the News and Star, surveyed the population on this issue--it is called a vox pop. Nine out of 10 people interviewed thought that it was a good idea that their insurance companies--not they--should pay the NHS to treat road accident victims in the same way as those companies pay to repair the vehicles involved in the accidents. The proposal is popular. I am pleased that the Secretary of State is introducing the Bill and that it will be implemented by April. [Interruption.] I am glad that the right hon. Member for Maidstone and The Weald thinks that that is funny.

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