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3.55 pm
Sir Robert Smith: I did not intend to speak, but the Minister refused to take an intervention on a point that interested me. It is a pity that Ministers are not more willing to take interventions; if they were, that could speed up our proceedings. He seemed to be saying that the fact that a motorist pays a higher premium proves that he is a more dangerous driver than others. It would be more correct to say that the motorist comes from a category that insurance companies consider to be a higher risk. Young motorists can be perfectly safe drivers, but they are penalised with a higher premium because they come from a group that is seen to have a higher risk of causing accidents.
The Bill will cause some drivers to pay considerably higher premiums because, as others have said, one cannot get something for nothing. If the Government are right, and the money can be delivered to the health service at no extra cost, why are they not aiming for a higher sum? If there is no cost to be met, they should be raising far more.
On Second Reading, our health team made it clear that the Bill should be opposed on principle. Having heard the arguments in Committee, I feel even more strongly that it should also be opposed on Third Reading. I am disappointed by the Government's attitude to the concept of retrospective legislation and their inability to accept any compromise or meeting of ways. They insist that, because something has been announced by a Minister, it must, de facto, be assumed that it will become the law of the land. That is absurd if we are to continue to have a legislative process and a House of Commons.
Other Departments have accepted amendments or compromises and agreed to introduce changes on Report or in another place, in response to concerns expressed in Committee or by groups outside. To say that, because insurance companies will have read in the newspapers that the Chancellor has declared that he wants to do something, it must be calculated, ipso facto, that that will definitely happen is a disgraceful way to treat the House and the country. The Chancellor has made other claims on which he has not delivered. He cannot have it both ways.
It must be accepted that, until legislation has passed all its stages, the process of lobbying and the right to make changes continue to exist. In this Parliament, with such a large majority, the Government seem to have decided to close their ears to representation and they are telling the wider public that they do not want to hear their views because they do not plan to act on them.
Mr. Syms:
I have followed the Bill's progress on Second Reading and in Committee. The debate has been interesting and we have not always reached the expected conclusions. The Minister said that the legislation would be judged on whether it streamlined the process and created an improved, more efficient scheme. Certain aspects of the Bill will certainly improve the scheme. The abolition of the emergency treatment charge has been widely welcomed by Government and Opposition Members.
Our earlier debate on whether the charge should remain for general practitioners or private hospitals was somewhat bedevilled by lack of information on both sides. We were not quite sure what was collected, who collected it or whether it was worth collecting. The Government said that they did not want to get rid of it because the GPs would be unhappy and some Opposition Members said that perhaps it was not worth having, but we did not have enough information to take the debate much further.
As my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) said, there is a point of principle at stake, because the Government have gone for a group of insured people in order to raise money. Throughout debate on the Bill, we have asked whether the Government have started on a slippery slope that will lead to more charges for, perhaps, home owners or for people involved in skiing or other sporting accidents. The official Opposition have expressed concerns that the Bill will breach a principle, and consequently affect many people's lives.
We support funding the national health service through general taxation and we believe that it should be free to those who use it. However, all Governments have to consider ways to supplement the health service's income and it has been an education to watch how quickly this Government have moved to try to raise money from private motorists. The Minister said that careless drivers would pay the charge, but, as the hon. Member for West Aberdeenshire and Kincardine (Sir R. Smith) pointed out, the young pay higher insurance premiums than other drivers, as do certain categories of people with medical difficulties. The insurance companies determine those charges, but if--as most Conservative Members believe--the Bill leads to higher insurance premiums, some of those least able to afford the charges may be affected.
In Committee, I raised the pot of gold argument. The Government have taken the credit for some £120 million to £160 million additional resources for the NHS, but they seemed to suggest that it would come from nowhere and not cost anyone because the charge was in place and the insurance companies were collecting it. However, as my hon. Friend the Member for Runnymede and Weybridge said, the money will have to come from somewhere, and we all know that it will come from charges by insurance companies on motorists. Motorists will pay an extra £120 million to £160 million, which will fund the NHS. That may not be a bad outcome, but the Government should be more open and acknowledge that motorists face an additional charge.
We also raised the issue of retrospective legislation. On 2 July 1997, the Chancellor announced a charge, without giving any details. Even if an insurance company had rapidly decided that it wanted to recoup the charge, it would not necessarily have been able to do so. I hope that the Government will reconsider that issue.
We have been accused of scaremongering, but we have pointed out that the money will have to come from somewhere. It will be raised by charging more to certain categories of motorists and some people will pay much more than they currently do. My hon. Friend the Member for Runnymede and Weybridge pointed out that we have to judge whether the Bill is a fair, equitable and sensible measure. Indeed, we are in favour of the Bill in principle, but the devil is in the detail. It is important that we have full scrutiny of the Bill's effect, and we must review the collection agency and its efficiency and effectiveness in collecting the charges. We must also review how the money is distributed to hospitals and health authorities.
Mr. Simon Hughes:
We are coming to the end of proceedings on this short Bill and I am grateful to my hon. Friends the Members for Oxford, West and Abingdon (Dr. Harris) and for West Aberdeenshire and Kincardine (Sir R. Smith), who looked after our interests so diligently in Committee. On Second Reading, when we supported the Conservatives' reasoned amendment, we said that this measure was not the right way to raise money for the health service.
When the Labour party came to office, it discovered a potential source of extra money for the NHS and, as the hon. Member for Runnymede and Weybridge (Mr. Hammond) said, it decided to make it produce more money--10 times more, an increase from £16 million to £160 million. However, we still do not know whether the Bill is an admission that the Government will look openly at the funding of the health service or a one-off response to an opportunity to raise more money by increasing an existing charge. The Government said nothing about such a move in their manifesto or during the general election, but it will mean that some people will make an additional contribution to the health service.
On Second Reading, we said that we did not like the Bill but that we would see what happened to it in Committee. I was not a member of the Committee, but I understand that proceedings there followed the same pattern as today's. For example, we made the sensible proposition, in new clause 1, that we should abolish the system under which general practitioners, such as my hon. Friend the Member for Isle of Wight (Dr. Brand), may collect money directly from someone involved in a road accident. General practitioners do not like to do that and most of them do not do so. We suggested that GPs should be paid for that service in the same way that they are paid for emergency treatment. That is a sensible proposition, but we have seen no movement in our direction by the Minister.
We also argued, with support from the Conservatives, that the legislation should not be retrospective. I am a lawyer by training and I have always sought to defend people against retrospective legislation. Whether its effect is big or small, the principle is wrong. We suggested that the date should be changed, but the Government have not conceded the point. The only concession made was on the need for clearer statistics, although the Minister was not very helpful when he was asked by my hon. Friends how many non-NHS and NHS doctors had said that they were in favour of the system. The Minister said that he had received representations, but he would not tell us how many.
The core issue is the financing of the health service. We will vote against Third Reading of the Bill because we cannot have uncertainty about how money for the NHS will be raised. It will be the Government's fault if, in the future, different categories of people are required to make contributions to the health service because they have been injured when undertaking certain activities. There is no difference in principle between people who drive and are involved in an accident paying into the health service through their insurance companies and
people who go on sporting holidays and are injured--like my hon. Friend the Member for Montgomeryshire (Mr. Öpik), when he went paragliding--doing so. If we extend the principle behind the Bill, there is no reason why my hon. Friend should not pay for his treatment. By the same token, people who are injured in their local park, at their place of work or climbing up a ladder at home should have to pay. There is no logic in charging only those involved in road accidents because they could have been charged in the past. People do not believe the Government's claims on that point.
I am in favour of more funds for the health service, but I would also like to see a public debate about how to raise them and the Government have not so far responded to that. As my hon. Friend the Member for West Aberdeenshire and Kincardine said, we feel less reassured after proceedings on the Bill than we did before. We have supported from the beginning the Government's uncontroversial proposals to abolish the emergency treatment, but the Bill contains much more.
We shall once again try, therefore, to defeat the Bill, this time on Third Reading. It is, I expect, unlikely that we shall succeed, but if we do not try, we cannot succeed. Our consolation is that, whatever the hon. Member for Bolsover (Mr. Skinner) may think, we have a two-chamber Parliament. The other House has no Labour majority, and it contains many independent people of expertise and knowledge who may amend the Bill. We hope that the Bill will be amended in the way that we have proposed. The Government have not done so, and, no matter how unsupportable their arguments have been, they have remained resolute in opening the door to charges in the health service that have never been part of rational debate. We ask the House to reject the Bill, and to reconsider health service charging in another place, at another time and in a more comprehensive way.
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