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Ms Drown: Did the previous Government point out that anomaly during discussion on the Road Traffic Bill in 1988? Can the hon. Gentleman distinguish between the compulsory insurance required by people who drive cars and non-compulsory insurance, which applies to some of his other examples?

Mr. Syms: The hon. Lady makes a good point. Motoring insurance is compulsory, although not everyone takes it out. A number of people caught in accidents are not in fact insured, and one of my problems with the Bill is that it fails to address that situation. The burden will fall on law-abiding citizens who conform to rules, regulations and laws, and who may have to pick up the tab for the bad apples who are uninsured.

The principle of insuring oneself for certain activities is recognised. People take out insurance for various sports.

Miss Begg: Will the hon. Gentleman clarify whether he is suggesting that, because some people break the law by not taking out compulsory insurance, we should not accept the Bill?

Mr. Syms: I am not suggesting that; I am merely saying that it is a fact of life that many people who should be covered by motor insurance are not covered. Under the Bill, the Motor Insurers Bureau run by the insurance companies will have to cover claims for those people who have not done their duty.

Miss Begg: Should we, then, frame legislation to take account of those who break the law or do not fulfil their obligations? Is that what the hon. Gentleman is saying?

Mr. Syms: No, that is not my point. Many people are insured. The Government's proposals will hit law-abiding citizens, who have already been hit by increased motoring taxes, including an increase in fuel taxes. The Bill does nothing to deal with uninsured drivers, and we should put

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more emphasis on making sure that they are insured, and on punishing them if they are not. I am sure that hon. Members on both sides of the House will agree with that.

My more general point is that to argue for the principle that drivers should pay through their insurance--compulsory or otherwise--is to set off on the slippery slope of arguing the same for other, more voluntary, activities. In rural areas, people need cars, and most Members of Parliament need cars to conduct our business.

Mr. Gareth R. Thomas (Harrow, West): May I bring the hon. Gentleman back to the point made by the hon. Member for Uxbridge (Mr. Randall) about great variations in the amounts that hospitals claim? The reason suggested was the complexity of the process. Does the hon. Gentleman agree that the Bill is excellent, in that it will simplify the process and help to eliminate variations in what is claimed around the country?

Mr. Syms: We shall have to test that point in Committee to see whether the Government's intentions--with some of which I agree--will have the planned results. Aspects of the Bill are positive, but many questions will be raised as the Bill progresses. There are concerns about the precedent being set, which may affect other areas. As a Conservative, I believe that the NHS must be basically free and paid out of national taxation. Income can be supplemented in one or two ways, but we all know that there is no effective way to pick up the NHS bill, except through general taxation.

5.55 pm

Laura Moffatt (Crawley): There will be a huge cheer throughout national health service trusts today when staff learn that the Bill has set off on its passage. Anyone in the NHS who has had to collect the £21.30 charge will tell hon. Members what nonsense that was. The Bill only makes possible what should have happened already. It contains nothing new, and it breaks no principles. Anyone who claims that a new principle is being introduced is neither right nor honest.

Is it reasonable to expect hard-pressed NHS staff to chase small sums? Those staff become completely disillusioned, dropping the chase when they have had enough. My local trust serves part of the M25, and it has to deal with lots of accidents, but it raised only £70,000 last year from the charge. Two people had to be dedicated to collecting small sums, and they were driven into the ground and became fed up. It is little wonder that some trusts paid heed to companies that offered to collect the debts, raising cash for the trusts, but taking a cut for themselves. That is clearly unacceptable.

However, matters are even worse than that. Some companies offer to look into the people involved in accidents, and then to organise retrospective insurance. The company then gets a cut for the hospital, and for the person who is making the claim. Tacky, nasty arrangements are being made over funds that should by right go to the NHS. I am glad to see the back of all that, and I look forward to putting a stop to companies making money from a difficult situation.

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Charging should be in the hands of people who know what they are doing. The compensation recovery unit is used to dealing with such matters.

Mr. Letwin: How successful has the compensation recovery unit been? What percentage of claims sought over the past five years has the unit managed to obtain?

Laura Moffatt: Clearly, I am not able to answer that. I can answer only for constituents who have experienced the work of the compensation recovery unit, and who have had no complaint about the ways in which they were asked to pay back benefit that they had received while waiting for claims to be resolved.

The compensation recovery unit is used to dealing with such matters. I hope that patients and hospitals will see little evidence of administration, and that the emotive subject of money need not be raised with people at difficult times. I trained as a nurse with my local trust, and I worked in the accident and emergency department, in which everyone had an opportunity to work, both during and after my training. It is awful to have to tell a patient that he or she may be charged a levy, and that we need a name and address so that we can make the charge. False names and addresses are still given to hospital staff, and that is clearly unacceptable.

The hon. Member for Uxbridge (Mr. Randall) mentioned the response of the Royal College of Nursing. I was interested to hear the hon. Gentleman say that the royal college was concerned, as it very much welcomes these moves. It produced two pages welcoming what the Government are trying to do, and its one small word of warning concerned ensuring that the principles were not taken further, which would be my warning too. I can support the measure only because compulsory insurance is involved, and I support it wholeheartedly. We will stick to that principle. The Royal College of Nursing, as a caring organisation, is right to say that we must be sensitive when we are claiming money from people who have been involved in difficult and horrible situations. I do not want the principle to be extended to other accidents.

I listened with interest when my hon. Friend the Member for Wakefield (Mr. Hinchliffe) talked about insurance and said that he would be covered if he had an accident. That would not be true of my three sons, who play for Crawley rugby club. The club encourages a sporting activity that enables our young people to join in, have great fun and keep fit. The last thing that I want is to cause them difficulty. The principle must rest there; it would not be acceptable to take it further.

I support the Bill because motor insurance is compulsory and the money will go back to the NHS, as it so rightly deserves. As a nurse in the NHS for 25 years, I have been waiting for such a measure. Staff are involved in issues with which they do not feel comfortable. The Government say that they will do something about that. They will ensure that staff do not have to be involved and that the NHS merely needs to know the names, addresses and types of treatment that have been given in a hospital. They will take the matter out of the nurses' hands, which will clearly be music to the ears of people who work in the NHS throughout the land.

Mr. Randall: Given the hon. Lady's experience as a nurse, does she think that the measure will involve more paperwork for nursing staff?

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Laura Moffatt: I can envisage only a reduction in paperwork. The hon. Gentleman should speak to those working in his local trust. In mine, two people have to spend most of their day chasing small sums. There will be a great reduction in the amount of paperwork. The job will be done elsewhere, by people who are used to doing it, which seems to be the only way forward.

Mr. Randall: I thank the hon. Lady for giving way again. She is most kind. With respect, I accept, as I said in my speech, that the money that trusts get back varies greatly. Under the Bill, will there have to be paperwork for all, or nearly all, patients who have been involved in a road traffic accident--paperwork that will have to be sent to the central collection point?

Laura Moffatt: Perhaps the hon. Gentleman has not noticed, but there is paperwork when most patients are admitted to an accident and emergency department. That work has to be done--there is no question about it--and it is the way in which it is done that matters. Another authority will deal with it further and the staff will be relieved when they hear that they will no longer have to pursue claims. The Bill is about bringing fairness back into the system. If a Labour Government are about anything, they are about fairness. Military hospitals have been included in the provisions of the Bill and will now be able to claim money. They will get the money that is due to them.

The Bill is a fitting tribute and a fitting approach to the national health service in its 50th year. I am glad that the Labour Government are taking us along that path and ensuring that the NHS gets the money that it so rightly deserves. NHS staff throughout the country will be grateful.


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