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Timetable


1.--(1) Proceedings on Consideration and on Third Reading of the Health Bill [Lords] shall be completed at the sitting this day and shall be brought to a conclusion, if not previously concluded, five hours after the commencement of proceedings on this Motion.


(2) Proceedings on Consideration and on Third Reading of the Immigration and Asylum Bill shall be completed in two allotted days and, if not previously concluded, shall be brought to a conclusion at midnight on the second allotted day.

Questions to be put


2.--(1) For the purpose of bringing any proceedings on either of the Bills to a conclusion in accordance with paragraph 1 the Speaker shall forthwith put the following Questions (but no others)--


(a) any Question already proposed from the Chair;
(b) any Question necessary to bring to a decision a Question so proposed;
(c) the Question on any amendment moved or Motion made by a Minister of the Crown;
(d) any other Question necessary for the disposal of the business to be concluded.
(2) On a Motion made for a new Clause or a new Schedule, the Speaker shall put only the Question that the Clause or Schedule be added to the Bill.
(3) If two or more Questions would fall to be put under sub-paragraph (1)(c) on amendments moved or Motions made by a Minister of the Crown, the Speaker shall instead put a single Question in relation to those amendments or Motions.

Miscellaneous


3. Standing Order No. 15(1) (Exempted business) shall apply to proceedings--


(a) on the Health Bill [Lords];

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(b) on the Immigration and Asylum Bill at the sitting this day until midnight;
(c) on the Immigration and Asylum Bill on the second allotted day;
and those proceedings shall not be interrupted under any Standing Order relating to sittings of the House.
4.--(1) If at the sitting this day--
(a) a Motion for the Adjournment of the House under Standing Order No. 24 (Adjournment on specific and important matter that should have urgent consideration) stands over to seven o'clock, and
(b) proceedings on this Motion have begun before that time,
the Motion for the Adjournment shall stand over until midnight.
(2) If on the second allotted day a Motion for the Adjournment of the House under Standing Order No. 24 stands over to seven o'clock or from an earlier day, the Motion shall stand over until the conclusion of any proceedings on the Immigration and Asylum Bill.
5. Standing Order No. 82 (Business Committee) shall not apply to proceedings on either of the Bills.
6. No Motion shall be made, except by a Minister of the Crown, to alter the order in which any proceedings on either of the Bills are taken or to recommit either of the Bills; and if a Minister makes any such Motion, the Question on the Motion shall be put forthwith.
7. No dilatory Motion shall be made in relation to either of the Bills except by a Minister of the Crown; and if a Minister makes any such Motion, the Question on the Motion shall be put forthwith.
8. The proceedings on any Motion made by a Minister of the Crown for varying or supplementing the provisions of this Order shall, if not previously concluded, be brought to a conclusion one hour after they have been commenced; and Standing Order No. 15(1) shall apply to those proceedings.
9. If at the sitting this day the House is adjourned, or the sitting is suspended, before the conclusion of proceedings on this Motion or on either of the Bills, no notice shall be required of a Motion made at the next sitting by a Minister of the Crown for varying or supplementing the provisions of this Order.

Interpretation


10. In this Order 'allotted day' means this day and any other day on which the Immigration and Asylum Bill is put down on the main business as first Government Order of the Day.

Dr. Evan Harris (Oxford, West and Abingdon): On a point of order, Mr. Deputy Speaker. I assume that the Government intend, later in the debate, to introduce the issue of their consultation paper on the regulation of the private health care system, which was promised before further progress was made on the Bill. I was concerned that the document was not available to me in the Vote Office, although it has been published, and it has not been sent to Front-Bench spokespersons. I know that it is available only because copies that were sent to a Labour Back Bencher who chairs the Select Committee on Health arrived in my office by mistake. I should be grateful for your guidance as to whether it is appropriate and in order for the Government to refer to a document that has been published but which Opposition Front-Bench Members have not had a chance to read.

Mr. Deputy Speaker: Order. That is not a matter for the Chair, but I hope that Ministers will look into it.

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Orders of the Day

Health Bill [Lords]

As amended in the Standing Committee, further considered.

New Clause 4

Criteria for appraisals by the National Institute for Clinical Excellence


"The Special Health Authority known as the National Institute for Clinical Excellence shall make its appraisals of different treatments and clinical interventions on the basis of clinical efficacy or relative cost-effectiveness compared with alternative treatments or clinical interventions for the same symptoms, but not on the basis of their affordability in relation to the funds available to the National Health Service."--[Dr. Harris.]

Brought up, and read the First time.

Question proposed, [14 June], That the clause be read a Second time.

7.46 pm

Question again proposed.

Mr. Deputy Speaker (Mr. Michael J. Martin): I remind the House that with this we are discussing new clause 14--National Institute for Clinical Excellence (duties and consultation with public)--


'.--(1) The Special Health Authority known as the National Institute for Clinical Excellence (the "Authority") shall meet in public.
(2) The Authority shall publish annually a report on its activities during the preceding calendar year which the Secretary of State shall lay before Parliament.
(3) The Secretary of State shall establish a public consultative committee in relation to the Authority, which shall have the duty of advising the Authority on the public's view on the priority to be accorded to different treatments and clinical interventions within the NHS.
(4) The constitution and membership of the committee mentioned in subsection (3) shall be such as the Secretary of State may determine in Regulations.'.

New clause 16--Protection of doctors' clinical freedom to prescribe appropriate drugs--


'.--The Secretary of State shall not exercise his powers to include a drug in schedule 11 to the National Health Service (General Medical Services) Regulations 1992 (as subsequently amended) in such a way as to restrict the circumstances in which the drug may be prescribed by reference to the different underlying causes of the symptoms for whose treatment it is clinically effective.'.

New clause 17--Cost or affordability not to be criteria for restricting prescribing of drugs--


'.--In issuing guidance on prescribing, or in exercising his powers to include a drug in schedule 10 (drugs and other substances not to be prescribed for supply under pharmaceutical services) or schedule 11 (drugs to be prescribed under pharmaceutical services only in certain circumstances) to the National Health Service (General Medical Services) Regulations 1992 (as subsequently amended), the Secretary of State shall not base his decision on the criterion of either the cost or the affordability of the drug in question.'.

Mr. John Bercow (Buckingham): The House will be delighted to learn that last night I was bringing my remarks, which had necessarily to be brief, to a conclusion when an untimely interruption to our business took place. I am happy to round up my remarks now.

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We are concerned about the National Institute for Clinical Excellence and the new clauses relating thereto. I have made the point before, and I underline it now, that there is interest in, but considerable concern about, the future direction of the national institute. It is for the Minister of State to assuage our concerns.

Will NICE be genuinely independent, given the framework agreement--to use the Minister's term--within which it will have to operate? Will it be possible for the national institute, when it is up and running, to exercise its own judgment without interference, public or private, from Health Ministers or Department officials acting on their behalf?

Will the Minister assure us that the national institute's assessments of treatments for conditions will take into account not only clinical cost-effectiveness but other costs that should properly form part of the equation? Will it be able to consider, make a judgment on, and draw up recommendations based on the social costs of opting for, or of failing to provide, one treatment or another? Those are crucial judgments at the heart of the new clauses.

Yesterday evening, in the absence of any significant contribution to the debate from Labour Members, it was left to Conservative Members to represent their constituents' interests and to scrutinise the Executive. We had a little assistance from Liberal Democrat Members, and it would be churlish to deny that. The Minister of State had a relatively easy time as he listened to us. This evening, we need to hear from him. What are his answers to our questions? What form will the body take? Can he produce the evidence? Is he capable of assuaging the legitimate concerns of the official Opposition, of the Liberal Democrats, and much more important, of millions of people throughout the country who are waiting to find out what sort of creature NICE is? We have made our case, and await a response.


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