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5.38 pm

Miss Anne Begg (Aberdeen, South): I would like to take this opportunity to describe my experience of the existing legislation. Let me take the House back to a snowy January morning in 1996, when I was driving my fairly new car--a spanking red car that was only two months old--near Brechin and Arbroath as I was going to work. It was a snowy morning with a lot of black ice. Water had been running across the road and had frozen. I was tentatively driving up a narrow, winding back road--taking my time because I knew of the dangers of the road. It was a classic accident spot.

Imagine my shock and horror when I saw another driver come around the corner towards me. I could see the fear and alarm on her face, and it was obvious that her car had hit a piece of black ice. I do not know whether anyone in the House has been in the situation where an accident is about to happen, but it happens in slow motion. I could see the expression on her face as her car slid across the road. She would quite happily gone off the road and into some trees, but I happened to be in the wrong place at the wrong time. Before the impact, my last thought was, "My nice new car!" There was nowhere for me to go as her car ploughed straight into the side of my car.

I was lucky--I had my mobile phone and I quickly dialled 999 to report the accident. Before long, an ambulance was there to cart me off to hospital. It was an occasion when it was quite good that I was in a wheelchair because, in standing on my brakes to try to stop the accident, I had done something to one of my feet. It had swollen; possibly a bone was broken--I did not know. I got my wheelchair out of the car and got myself

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into it. By the time the ambulance had arrived, I was mobile, but obviously something was fairly seriously wrong. Also, I had broken my sternum from wearing the seat belt. The ambulance took me to the local hospital, Stracathro hospital, where I was patched up and duly dispatched home.

At this point, I was glad that I had ticked the small box on my insurance form that ensured that I would have legal representation should I have an accident. The insurance company appointed a lawyer, who went into action on my behalf to claim some personal injury compensation.

I was able to claim a small amount to compensate for my pain and suffering, but I also had to claim back my wages for the two days for which I had been off work, despite the fact that my employer would have paid my wages in any case. As a teacher working for a local authority, I was covered by all the normal statutory sick pay arrangements, but because I was claiming personal injury compensation, my employer expected recompense for the two days' work that he did not get from me.

I expected to have to claim something to pay for hospital bills, but it did not happen. I had that expectation because, 20 years earlier, I had had another accident. I do not want hon. Members to think that I make a habit of having accidents. It was a snowy evening in March, and on this occasion I was driving down a road in Dundee when someone came out of a side road, tried to brake, did not stop and came straight across my path--another example of my being in the wrong place at the wrong time. I was collected by an ambulance and taken to the Dundee royal infirmary.

After that earlier accident, a bill arrived at my house, which I thought was to cover the cost of the ambulance. I have learnt only this afternoon, by listening to my right hon. Friend the Secretary of State, that the bill was not for the ambulance. I remember feeling alarmed that I had to pay for the ambulance, until someone told me that the bill would be met by the other person's insurance.

Therein lies the problem: two different health authorities, and two almost identical accidents, but in one I--or the insurance company of the person who caused the accident--was not charged, while in the other a charge was made. That is the anomaly that the Bill will put right. The power already exists, and is exercised in some areas, to charge for hospital treatment resulting from an accident; but it is used sporadically and inconsistently. It is used by some health authorities on some occasions and by others not at all.

What is the point of legislation if it cannot be enforced and the money cannot be recouped? That is why I welcome the Bill. It will make the recovery of costs much easier and there will be much greater consistency. It is different from existing legislation because of the compensation recovery unit, which will take the responsibility for recouping the money for the hospital out of the hands of the individual and put it squarely on the shoulders of the insurance companies. The law will be more coherent and therefore much better.

I welcome the Bill because it will create a much fairer system. It will apply to everyone equally and I hope that, as a result, the health service will continue to be able to put extra resources in the areas of greatest need, improving accident and emergency treatment, modernising the equipment in ambulances and reinvesting funds in the health service to make it the jewel in the crown that makes us so proud to be British.

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5.44 pm

Mr. Robert Syms (Poole): In such an interesting debate on the subject of charging in the national health service, one can confidently predict that each side will accuse the other of being inconsistent. On both the Government and the Opposition Benches we have a history of arguing certain cases. Car parking charges are one of the topics that have already been mentioned. Consistency may not ring out from either side of the Chamber tonight.

Regardless of the existing law, the NHS charges have not been collected. If the Bill introduces a more efficient collection system, motorists will ultimately have to pay via their insurance companies. In effect, the Bill brings about an indirect tax rise, against the background of major increases in motoring costs initiated by the Government, as my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) argued.

Everyone contributes to the NHS through general taxation. Motorists will, in effect, be charged twice. Having paid through general taxation, they will be expected to pay again through their insurance. It is estimated that the Government's proposals will cost motorists an extra £10 a year in increased premiums. Seen in the context of £9 billion of extra motoring taxes, it is clear that many motorists will find the additional cost difficult to meet.

During the debate, the Opposition will seek assurances that the proposals are not the thin end of Labour's charging wedge. It is easy to claim that increased charges are justified in one part of the NHS, but good arguments can be made for higher charges for other NHS services.

The Bill has implications for bureaucracy. Additional money may well be raised, but that will entail costs, as 50 people will be employed in the collection unit.

Insurance premiums will rise by about £9 a year. As my hon. Friend the Member for Uxbridge (Mr. Randall) noted, the Automobile Association estimates a £10 increase, but that remains to be seen. The fact that costs will be absorbed by the Motor Insurers Bureau means that the uninsured may be paid for by the insured. That is not compatible with natural justice. Higher insurance premiums are hardly likely to increase the number of motorists who take out insurance. The Association of British Insurers estimates that uninsured drivers will cost motorists £250 million in 1999. The Bill could increase that sum substantially.

Many motorists' costs are paid by businesses, so business costs will rise. There are 1.6 million company cars. The additional burden on business will have to be financed from trading.

The charges could be judged to be an unfair levy. Motoring in the United Kingdom is already more expensive than elsewhere in Europe.

Anomalies will inevitably arise, and perhaps the Minister will respond on this point at the end of the debate. I mentioned earlier the example of an aircraft careering off a runway into a road. If someone falls off a ladder in his home, there would not necessarily be a claim against his home insurance. The case of cyclists has been mentioned. Other examples are that of a ferry sinking or a train or aircraft crashing.

Mr. Andrew Dismore (Hendon): Aircraft and shipping accidents are covered by international conventions, so a

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Government could not legislate for those cases, even if they wanted to do so. The Athens convention deals with shipping accidents and the Warsaw convention with aircraft accidents.

Mr. Syms: The hon. Gentleman makes an interesting point. I am sure that such issues will be explored more fully in Standing Committee, on which I may volunteer to serve. The Bill creates a regressive tax without regard for whether someone is rich or poor. Indeed, some poorer households pay rather more of their income in insurance than do some richer households.

The Bill also raises questions about the future funding of the national health service. If we introduce the principle that motorists should contribute through their insurance companies, we shall have to deal with arguments about why that should not be so for smokers, drinkers or the overweight. Self-inflicted injury has been mentioned. Those who take part in dangerous sports might also be affected. We must address the anomaly of having a charge for motorists--probably because there is already a substantial insurance market which can be tapped--while there is no charge in other areas. There is also concern about extra bureaucracy.

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