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Mr. Hinchliffe: If the hon. Gentleman reads my speech tomorrow, he will see that I did not say that. I specifically distanced myself from proposals to extend the scheme, as he is suggesting. Will he deal with the point that I made on the inconsistency between the reasoned amendment tabled by the shadow Health Secretary and her colleagues and the previous Government's introduction of car- parking charges?

Mr. Duncan: The inconsistency today is among Labour Members--some of whom want to extend the scope of the scheme, some of whom want to reduce it and some of whom want to keep it as it is. They are totally at odds one with another.

My hon. Friend the Member for Uxbridge (Mr. Randall) rightly pointed out the effect on motorists of charging.

The hon. Member for Aberdeen, South (Miss Begg) vividly described the crash that she herself suffered. So well did she describe it that, for a moment, I almost felt that I was in that car. However, she was yet another Labour Member welcoming NHS charges as proposed in the Bill.

My hon. Friend the Member for Poole (Mr. Syms) made it clear that a charge is a charge. He spoke of the effect of uninsured motorists, and drove a coach and horses through any remaining pretence that the Government have any consistent principle in their thinking.

The hon. Member for Crawley (Laura Moffatt) seemed to give full support for national health service health insurance, and admitted that it would be a compulsory charge for NHS treatment.

My hon. Friend the Member for West Dorset (Mr. Letwin)--who has apologised to you, Mr. Deputy Speaker, and to the House for not being able to stay for the conclusion of the debate--ably described how the Government are so devoid of principle that, in the Bill, they are doing the opposite of what they led the electorate to expect before the general election. Although I was very grateful for his kind words about my libertarian credentials, I was more grateful to him for cogently dissecting what I and everyone else now recognise as the Government's intellectual poverty.

The hon. Member for South Swindon (Ms Drown) is a public sector accountant. Therefore she, above all, should know about compulsory insurance. However, she made no case as to why only motorists should face paying such a charge.

The hon. Member for Oxford, West and Abingdon (Dr. Harris) made yet another plea for some expression of principle by the Government. I fear that his plea will have fallen on deaf ears.

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The hon. Member for Hendon (Mr. Dismore) clearly is new Labour. He tried to give credit for the Bill to the grandfather of the Secretary of State for Trade and Industry. If the hon. Gentleman drives as fast as he speaks, he will always be done for speeding. He wishes to extend the charging concept, whereas the hon. Member for Wakefield--who is sitting behind him--does not.

The hon. Member for Harrow, West (Mr. Thomas), too, seems to be totally at odds with the hon. Member for Wakefield.

The Government's approach to the Bill demonstrates their incoherence on the overall issue of national health service charging and on the way in which money in the health service works. The Secretary of State keeps saying that there is no rationing; yet the Government--as they always have done--ration. He said that NHS charges must never exist; yet--in this very Bill--the Government most clearly will charge. The Bill will broaden the incidence of charging. The Secretary of State rails against charges, but today he promotes them. It is an extraordinary volte-face.

The Bill will increase the scope of charging for treatment, but where is its logic? What will happen next? Let us consider an example that is currently in the news. Barry Horne, an animal rights activist, is on hunger strike. No one has injured him; he is inflicting his condition on himself. He is in a hospital in Yorkshire and is a cost to the national health service. Does the Secretary of State think that he should be charged in some way for the treatment that he is receiving? Does he think that he should pay the costs of the delayed opening of the hospital's new cancer ward, if it is delayed?

Does the Secretary of State think that charging will eventually be applied to other places that are insured, such as offices and homes, where there might be a fire or an accident? Will charging be applied to train crashes or to dreadful, massive events such as Hillsborough or Zeebrugge when compensation is paid out?

Does the Secretary of State intend--perhaps he will do the House the courtesy of listening--that, one day, charging might extend to what is deemed a "class action" against tobacco manufacturers, so that those smokers--whose treatment clearly has imposed a cost on the NHS--also have to pay?

The logic of the legislation shows that it is not about risks that are compulsorily insured but about cases in which compensation happens to be delivered and in which, in the case of motorists, there happens to be compulsory insurance. It is an easy route to a wider charge. No proof of fault is required. There was no principle in the Secretary of State's statement about insurance being compulsory. The simple fact is that compensation in such cases can easily be traced and then returned to the national health service.

The costs of charging will be passed on. Estimates of the costs range from £50 million to £450 million. Even if the costs figure falls between the high and low estimates, they will cause motorists a notable expense.

Let us be clear about it: the Government's proposals will hereby extend compulsory charging for NHS treatment of motorists. Let us ignore the Secretary of State's words; let us look at his deeds.

Motorists will be hit--perhaps, if the higher estimate applies, quite hard. Motorists have already had to pay £9 billion extra in fuel tax. After today's announcement

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by the Deputy Prime Minister, they will probably have to pay road charges. Their vehicle excise duty has gone up, and they face a new car registration tax. Now, they will have to pay for the Bill's proposals.

I think that the Secretary of State probably used to attack the insurance premium tax, but now he is introducing another tax. He even had the gall to say that insurance premiums will not rise, and cited the case of Direct Line insurance, which essentially said that it already factored in the charges. A charge on an institution does not mean that the individual is not eventually charged. The Government are proposing a wider and more burdensome charge that will fall on the hard-pressed motorist. I urge the House to support our reasoned amendment.

7.30 pm

The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): As the hon. Member for Rutland and Melton (Mr. Duncan) said, this has been a lively debate. More importantly, it has been a well informed and useful debate, in which several hon. Members, particularly Labour Members, have brought their professional and personal experiences to bear on the issue. I should like to respond as fully as possible to the points that have been raised. If I am not able to cover all the points, I shall write to the relevant hon. Members when I have an opportunity for more detailed consideration.

I am afraid that the speech by the hon. Member for Rutland and Melton has come roughly 70 years too late. The subject matter of the Bill has been on the statute book for that long. As I am sure that he would be the first to admit, when the Conservatives had the opportunity to consider the issue, they endorsed the principle that we are debating.

We have heard sensible contributions from my hon. Friends the Members for Carlisle (Mr. Martlew), for Wakefield (Mr. Hinchliffe), for Aberdeen, South (Miss Begg), for Crawley (Laura Moffatt), for South Swindon (Ms Drown), for Hendon (Mr. Dismore) and for Harrow, West (Mr. Thomas). I shall also deal with some of the points made by Opposition Members.

My hon. Friend the Member for Carlisle welcomed the abolition of the emergency treatment fee, as did many other hon. Members. It will be widely welcomed, particularly in the national health service. He highlighted the inefficiencies of the present scheme and mentioned the benefits that the new arrangements will bring to the national health service in Cumbria.

The hon. Member for Southwark, North and Bermondsey (Mr. Hughes) appeared to be in favour of statutory mechanisms for setting the price of motor insurance, which I found curious. He proceeded to read out most of the Liberal Democrat reasoned amendment, which did not add much to our proceedings. He then tried manfully to distinguish it from the Conservative reasoned amendment, which he went on to say that he would vote for anyway. That is the Liberal Democrats.

Mr. Simon Hughes: Oh dear! We had hoped better of the new Minister, but he has yet to amend his ways. He

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has mentioned insurance contributions. Can he guarantee that insurance premiums for car drivers will not go up as a result of the Bill?

Mr. Hutton: I intend to deal with that later in my speech.

My hon. Friend the Member for Wakefield also welcomed the abolition of the emergency treatment fee and pointed out the inconsistencies in the Opposition position. He did us all a favour by drawing attention to the ambiguous position adopted by the Conservatives.

My hon. Friend the Member for South Swindon referred to her experience of trying to administer the existing arrangements. She spoke for many in the national health service when she welcomed the proposals. She described the existing arrangements as complicated and bureaucratic. I assure her that we want the new arrangements to be clear and straightforward. Local hospitals should benefit directly.

My hon. Friend the Member for Aberdeen, South made a persuasive and effective speech, drawing attention to the absurdities of the present arrangements and the fact that the national health service loses out. I welcome her support for the Bill. She also pointed out that the new arrangements will apply to the national health service in Scotland.

The hon. Member for Poole (Mr. Syms) repeated his concerns about the impact on motorists. I shall deal with that in a moment. He also expressed concerns about what he described as new bureaucracy in the arrangements. That is rich coming from the Conservatives. We are proposing a streamlined system for recovering the charges that are owed to the national health service. It is the best and least bureaucratic scheme that we can devise and it will deliver benefits to the national health service. Intriguingly, he said that he supported some parts of the Bill, but declined to say which. It is a shame that he is going to join his hon. Friends in voting against the Bill.

My hon. Friend the Member for Crawley welcomed the involvement of the compensation recovery unit. She brought her experience as a nurse to the debate on the emergency treatment fee. She rightly said that the Bill is about fairness.

I am sorry that the hon. Member for West Dorset (Mr. Letwin) is not in his place. Of course, that gives me an opportunity not to refer to his speech, which is a serious temptation. However, I should let my right hon. Friend the Secretary of State know that the hon. Gentleman expressed his admiration for him, which was gratefully received by Labour Members. Unfortunately, the hon. Gentleman spoiled it by failing to understand the terms of the Bill or the Government's policy. That revealed the confusion that underpins the Conservative response to our proposals. Sadly, he allowed the hatred of everything European to surface again. He deserves some praise for his ingenuity in getting Europe into the debate. Like other Opposition Members, he has sought to read more into the Bill than he should.

The hon. Member for Oxford, West and Abingdon (Dr. Harris) joined the hon. Member for Southwark, North and Bermondsey in showing that the Liberal Democrats do not have a coherent or rational position on this occasion--as on many other occasions. It is a mistake for them to join the Conservatives in opposing the Bill.


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