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Mr. John Randall (Uxbridge): My point is not meant to be confrontational. I know that the hon. Gentleman's constituency is in Cumbria. Does he think that the Bill's principle should be applied to people who come from outside that area to do mountaineering or hill walking because the local health service pays for their care if they are injured while taking part in those activities?
Mr. Martlew: The principle is specific to the Bill. The existing legislation, which has been in place since the 1930s, was amended by the previous Government in 1988, and all sides of the House have agreed to it. There is now some carping about the level of the charges. People are prepared to pay a little extra--that is all it will cost and if competition works properly, there might be no extra cost--through their insurance to ensure that payment is made to the NHS. If the Opposition do not believe that, they are out of tune with their electors.
Mr. Alan Duncan (Rutland and Melton): Will the hon. Gentleman explain what he believes to be the difference between motor insurance paying for someone's health care and general health insurance paying for such care?
Mr. Martlew: There is a great difference. This proposal is acceptable and has been since the 1930s. Any other proposal would be unacceptable and would go against our commitments. We gave a commitment on this measure and we shall stick to it.
Mr. Philip Hammond (Runnymede and Weybridge): Where?
Mr. Martlew: We made a commitment on charges and we are getting rid of several charges for people who are affected by the legislation. We shall reduce the number of those charges by three quarters. I am sure that when hospitals receive the money, the right hon. Member for Maidstone and The Weald and her hon. Friends will not say, "Send it back to those poor insurance companies.
They cannot afford it." They will accept the situation. Conservative Members are making mischief. I shall support the Bill.
Miss Widdecombe: The hon. Gentleman continually refers to insurance companies paying. How does he think that insurance companies get money if not from the people who insure with them?
Mr. Martlew: I have already said that if there is an extra charge, my constituents will accept that it is a price worth paying to support the health service. The insurance companies should have been paying that money all along. In some cases they have frustrated the hospitals' and trusts' claims for money by not co-operating. Time and time again, we find that the Tories would sooner support insurance companies than support the national health service.
5.3 pm
Mr. Simon Hughes (Southwark, North and Bermondsey): My colleagues and I will vote for the reasoned amendment in our names if it is selected by Madam Speaker or by you, Mr. Deputy Speaker. If it is not selected, we will vote for the amendment tabled by the right hon. Member for Maidstone and The Weald (Miss Widdecombe) and her colleagues.
Mr. Deputy Speaker: Order. Perhaps the hon. Gentleman was not present at the beginning of the debate when Madam Speaker announced that she had selected the amendment in the name of the Leader of the Opposition. That is the decision on the selection of amendments.
Mr. Hughes: In that case, we shall, perforce, support the amendment tabled by the Conservative Opposition because we cannot vote on our reasoned amendment. We have reservations about the way in which the right hon. Member for Maidstone and The Weald has drafted the amendment because it is rather pro-motorist.
Mr. Hughes: We are unhappy about that stance. The debate should be about how the health service raises money rather than whether motorists are clobbered by the measure. I shall turn to the details of that issue in a moment.
I apologise to hon. Members for the fact that the reasoned amendment in the names of my colleagues and myself, as I have already pointed out to the Secretary of State, the right hon. Member for Maidstone and The Weald and Madam Speaker, should have read, "on the grounds that it makes provision for payment by requiring those who successfully claim compensation for personal injury sustained in road traffic accidents but not by any other means". I do not know whether that omission was caused by my handwriting, my drafting or by an error somewhere else, but I hope that I have corrected the record.
As I told the Secretary of State during the debate on the Queen's Speech, we support the abolition of the emergency treatment fee. It was too bureaucratic to collect
the charge, and the cost of collection was not worth the candle of the payment. I share the Secretary of State's view that it had an indignity about it.
If that is out of the way, this debate is about changing the rules for collecting another source of money which, as the Secretary of State rightly said, has been available for collection since the 1930s. The Secretary of State's researchers may have done a better job than me. If it is true that my predecessors and the Secretary of State's predecessors--old though he is, he is not that old--voted--[Hon. Members: "Old Labour."] No, not old Labour, just old. If our predecessors voted for the measure in 1930 or 1938, that was almost two decades, or thereabouts, before the NHS came into being. Raising money for health services in those days was a whole different ball game from when we set up the national health service, which was voted for in this place by the Labour party and the Liberals and opposed by the Conservatives. We put in place a health service paid for by taxes, not charges. This debate is about whether this is a proper charge, a new charge and whether it should be supported.
I accept that, as the Secretary of State said, this is not a new charge. Therefore, I accept that in this Bill the Government have not broken any commitment not to raise any new charges to pay for the health service. It is an old charge, but it was not collected. It is a convenient source to which the Government can turn to add a bit more money to the kitty. I understand their reasons for doing it. It provides a way of raising money that is consistent with the Government's commitments.
However, it changes the amount of money raised through charges and, in that context, it is a little like the Government's announcement about raising prescription charges earlier in the year. Last year their policy was that raising prescription charges would be a tax on patients, the poor and the sick. This year, lo and behold, they raised them. This measure will mean that more money will be collected from charges, directly from the insurance companies but inevitably, as the right hon. Member for Maidstone and The Weald said, indirectly it will come from those who pay insurance companies. Insurance companies have no money of their own other than that paid to them. The Bill will increase the charges collected for the NHS from some of the people in Britain when they pay their motor insurance.
I doubt whether the motor insurance industry believes that it can do all that without putting up our premiums by a penny--only time will tell. I have never known a free lunch and I have never known insurance companies reduce charges when the bill for them has gone up. We will hear that debate in Committee and, no doubt, we will debate how much the charges might go up and when.
The reasons why my hon. Friends and I have reservations and cannot support the Bill on Second Reading are summarised in our reasoned amendment. We do not believe that it is principled to raise more money for the health service from charges. My party stands by a national health service paid for through taxation. There is a range of charges that contribute to the health service including prescription charges and appliance charges. There are also charges paid by pensioners, who are the only group in society who have money recouped if they
go into hospital because some of their pension is taken back. That does not mean that adding to an anomalous hotch-potch of charges is right. We do not think that it is.
At my party's conference this year we agreed a motion committing us to looking at all charges in the health service. I do not know the outcome of those deliberations, but, when we reach our conclusion, which will be well before the next election, we may decide to commit the party to abolishing those charges. It may be--
Mr. Kevin Hughes (Doncaster, North):
The hon. Gentleman's party will have to be in government.
Mr. Hughes:
We are moving towards that position as fast as the Labour party was before the general election.
Mr. Martlew:
Will the hon. Gentleman give way?
Mr. Hughes:
I shall give way in a moment.
As an eternal optimist and as someone who watches the political runes, I think that we are well on the way to being in government long before the hon. Member for Doncaster, North (Mr. Hughes) retires from politics, and certainly long before I and my hon. Friend the Member for Taunton (Jackie Ballard) retire.
Mr. Martlew:
How much will the policy of abolishing charges cost and how much would it be necessary to increase income tax to ensure that exactly the same amount of money went into the NHS as goes in now? There will be no betterment by abolishing charges and increasing tax, will there?
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