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Mr. Simon Hughes: About a year ago, when the Government asked the health service pay review bodies what they wanted to do, the Government set a precedent by telling the pay review bodies that they must take account of cost before recommending the level of salaries. That is a bad precedent, but it look as if the Government will go down the same road in relation to advice on rationing.

Dr. Harris: My hon. Friend is absolutely right. Because the Government will not rule out that option, professionals and friends of the health service must look at the Government's form--and, as far as the NHS is concerned, the Government have previously sought to run away from their responsibilities for the fact that the service is desperately short of funds.

The Minister refused to answer another question, which was asked badly by the hon. Member for Buckingham (Mr. Bercow) but which I shall put in a different way. If the National Institute for Clinical Excellence has to look at just the effectiveness and cost-effectiveness of drugs and treatments, will it be able to criticise Government policy--such as the Government's obsession with waiting lists--on the ground that it is an ineffective and non-cost-effective use of resources? I shall be interested to see whether the Minister can tell us now that the institute will be free to criticise Government policy and priorities. His decision to remain seated suggests that the institute will not be free to do that, which is a great pity. New clause 14 sought to bring the institute into thepublic domain. We are pleased with the Minister's

15 Jun 1999 : Column 231

response to subsection (1), but both the Government and the Conservative Opposition failed to understand that subsection (3) was intended to ensure that the patient's voice was heard in decisions about which treatments the institute would consider, rather than in decisions about whether the Government should engage in rationing. It is unfortunate that neither party decided to consider that. I am also concerned about the Government's response to new clause 16.

Mr. Hammond: Will the hon. Gentleman give way?

Dr. Harris: No. I want to finish my speech, and the hon. Gentleman has had plenty of time in which to speak.

Effectively, the Government are saying that new clause 16 would stop them from restricting the use of drugs as treatment for certain conditions when other treatment would be equally effective, both clinically and in terms of cost. Perhaps the new clause should have been drafted in those precise terms, but I am sure that the Government would have rejected it in any event. In the Minister's example, it was clear that the decision to restrict use of an anti-epileptic drug was based on its effectiveness, and relative cost-effectiveness, in certain conditions, rather than being based--as with the restrictions on the use of Viagra--on the original cause of the condition. That is highly discriminatory. In a similar manner, the Government wriggled out of the implications of new clause 17 by claiming that cost was the same as cost-effectiveness. Of course it is right for the Minister to be able to offer guidance on the use of a drug on the basis of cost-effectiveness, but the new clause refers to cost and affordability, so the Minister's answer does not wash. On the basis of all that, we shall press the motion to a Division.

Question put, That the clause be read a Second time:--

The House divided: Ayes 34, Noes 322.

Division No. 206 [8.15 pm

AYES

Allan, Richard
Beith, Rt Hon A J
Brake, Tom
Bruce, Malcolm (Gordon)
Burnett, John
Burstow, Paul
Cable, Dr Vincent
Chidgey, David
Cotter, Brian
Davey, Edward (Kingston)
Fearn, Ronnie
Forsythe, Clifford
Foster, Don (Bath)
Hancock, Mike
Harris, Dr Evan
Harvey, Nick
Hughes, Simon (Southwark N)
Keetch, Paul
Kirkwood, Archy
Livsey, Richard
Llwyd, Elfyn
Maclennan, Rt Hon Robert
Moore, Michael
Morgan, Alasdair (Galloway)
Öpik, Lembit
Rendel, David
Ross, William (E Lond'y)
Russell, Bob (Colchester)
Sanders, Adrian
Smyth, Rev Martin (Belfast S)
Stunell, Andrew
Tonge, Dr Jenny
Webb, Steve
Willis, Phil

Tellers for the Ayes:

Mr. Mark Oaten and
Sir Robert Smith.

NOES

Abbott, Ms Diane
Ainger, Nick
Ainsworth, Robert (Cov'try NE)
Alexander, Douglas
Anderson, Donald (Swansea E)
Anderson, Janet (Rossendale)
Ashton, Joe
Atherton, Ms Candy
Atkins, Charlotte
Barnes, Harry
Barron, Kevin
Battle, John
Beard, Nigel
Beckett, Rt Hon Mrs Margaret
Begg, Miss Anne
Bell, Martin (Tatton)
Bell, Stuart (Middlesbrough)
Benn, Hilary (Leeds C)
Benn, Rt Hon Tony (Chesterfield)
Bennett, Andrew F
Bermingham, Gerald
Berry, Roger
Best, Harold
Betts, Clive
Blackman, Liz
Blears, Ms Hazel
Blizzard, Bob
Blunkett, Rt Hon David
Borrow, David
Bradley, Keith (Withington)
Bradley, Peter (The Wrekin)
Bradshaw, Ben
Brinton, Mrs Helen
Brown, Russell (Dumfries)
Browne, Desmond
Buck, Ms Karen
Burden, Richard
Burgon, Colin
Butler, Mrs Christine
Caborn, Rt Hon Richard
Campbell, Alan (Tynemouth)
Campbell, Mrs Anne (C'bridge)
Campbell, Ronnie (Blyth V)
Campbell-Savours, Dale
Cann, Jamie
Caton, Martin
Cawsey, Ian
Chapman, Ben (Wirral S)
Chaytor, David
Clapham, Michael
Clark, Dr Lynda
(Edinburgh Pentlands)
Clark, Paul (Gillingham)
Clarke, Charles (Norwich S)
Clarke, Eric (Midlothian)
Clarke, Rt Hon Tom (Coatbridge)
Clarke, Tony (Northampton S)
Clelland, David
Clwyd, Ann
Coaker, Vernon
Coffey, Ms Ann
Cohen, Harry
Coleman, Iain
Colman, Tony
Connarty, Michael
Corbett, Robin
Corbyn, Jeremy
Corston, Ms Jean
Cousins, Jim
Cranston, Ross
Crausby, David
Cryer, John (Hornchurch)
Cummings, John
Curtis-Thomas, Mrs Claire
Dalyell, Tam
Darling, Rt Hon Alistair
Darvill, Keith
Davey, Valerie (Bristol W)
Davidson, Ian
Davies, Rt Hon Denzil (Llanelli)
Davies, Geraint (Croydon C)
Dawson, Hilton
Dean, Mrs Janet
Denham, John
Dismore, Andrew
Dobbin, Jim
Dobson, Rt Hon Frank
Donohoe, Brian H
Doran, Frank
Dowd, Jim
Drew, David
Drown, Ms Julia
Dunwoody, Mrs Gwyneth
Eagle, Angela (Wallasey)
Eagle, Maria (L'pool Garston)
Edwards, Huw
Efford, Clive
Ellman, Mrs Louise
Ennis, Jeff
Fisher, Mark
Fitzpatrick, Jim
Fitzsimons, Lorna
Flint, Caroline
Follett, Barbara
Foster, Rt Hon Derek
Foster, Michael Jabez (Hastings)
Foster, Michael J (Worcester)
Foulkes, George
Galloway, George
Gapes, Mike
Gardiner, Barry
George, Bruce (Walsall S)
Gerrard, Neil
Gibson, Dr Ian
Gilroy, Mrs Linda
Godsiff, Roger
Goggins, Paul
Golding, Mrs Llin
Gordon, Mrs Eileen
Griffiths, Jane (Reading E)
Griffiths, Nigel (Edinburgh S)
Griffiths, Win (Bridgend)
Grocott, Bruce
Gunnell, John
Hain, Peter
Hall, Mike (Weaver Vale)
Hall, Patrick (Bedford)
Hamilton, Fabian (Leeds NE)
Hanson, David
Heal, Mrs Sylvia
Healey, John
Henderson, Doug (Newcastle N)
Henderson, Ivan (Harwich)
Hepburn, Stephen
Heppell, John
Hesford, Stephen
Hewitt, Ms Patricia
Hill, Keith
Hinchliffe, David
Hodge, Ms Margaret
Hoey, Kate
Hood, Jimmy
Hoon, Geoffrey
Hope, Phil
Hopkins, Kelvin
Howarth, Alan (Newport E)
Howarth, George (Knowsley N)
Howells, Dr Kim
Hoyle, Lindsay
Hughes, Ms Beverley (Stretford)
Hughes, Kevin (Doncaster N)
Humble, Mrs Joan
Hurst, Alan
Hutton, John
Iddon, Dr Brian
Ingram, Rt Hon Adam
Jackson, Ms Glenda (Hampstead)
Jackson, Helen (Hillsborough)
Jenkins, Brian
Johnson, Alan (Hull W & Hessle)
Johnson, Miss Melanie
(Welwyn Hatfield)
Jones, Barry (Alyn & Deeside)
Jones, Mrs Fiona (Newark)
Jones, Helen (Warrington N)
Jones, Jon Owen (Cardiff C)
Jones, Dr Lynne (Selly Oak)
Kaufman, Rt Hon Gerald
Keeble, Ms Sally
Keen, Alan (Feltham & Heston)
Keen, Ann (Brentford & Isleworth)
Kelly, Ms Ruth
Kennedy, Jane (Wavertree)
Khabra, Piara S
Kidney, David
King, Andy (Rugby & Kenilworth)
King, Ms Oona (Bethnal Green)
Kumar, Dr Ashok
Ladyman, Dr Stephen
Lawrence, Ms Jackie
Laxton, Bob
Lepper, David
Leslie, Christopher
Levitt, Tom
Lewis, Ivan (Bury S)
Lewis, Terry (Worsley)
Liddell, Rt Hon Mrs Helen
Linton, Martin
Livingstone, Ken
Lloyd, Tony (Manchester C)
Lock, David
McAvoy, Thomas
McCabe, Steve
McCartney, Rt Hon Ian
(Makerfield)
Macdonald, Calum
McDonnell, John
McFall, John
McGuire, Mrs Anne
McIsaac, Shona
Mackinlay, Andrew
McNulty, Tony
Mactaggart, Fiona
Mallaber, Judy
Marsden, Paul (Shrewsbury)
Marshall, David (Shettleston)
Marshall-Andrews, Robert
Martlew, Eric
Maxton, John
Meale, Alan
Merron, Gillian
Michie, Bill (Shef'ld Heeley)
Milburn, Rt Hon Alan
Miller, Andrew
Moffatt, Laura
Moonie, Dr Lewis
Moran, Ms Margaret
Morgan, Ms Julie (Cardiff N)
Morley, Elliot
Morris, Ms Estelle (B'ham Yardley)
Morris, Rt Hon John (Aberavon)
Mountford, Kali
Mudie, George
Mullin, Chris
Murphy, Denis (Wansbeck)
Murphy, Jim (Eastwood)
Murphy, Rt Hon Paul (Torfaen)
Naysmith, Dr Doug
Norris, Dan
O'Brien, Mike (N Warks)
Olner, Bill
O'Neill, Martin
Osborne, Ms Sandra
Pearson, Ian
Pendry, Tom
Pickthall, Colin
Pike, Peter L
Plaskitt, James
Pond, Chris
Pope, Greg
Pound, Stephen
Prentice, Ms Bridget (Lewisham E)
Prentice, Gordon (Pendle)
Primarolo, Dawn
Prosser, Gwyn
Purchase, Ken
Quinn, Lawrie
Radice, Giles
Rammell, Bill
Reed, Andrew (Loughborough)
Reid, Rt Hon Dr John (Hamilton N)
Robertson, Rt Hon George
(Hamilton S)
Roche, Mrs Barbara
Rooney, Terry
Ross, Ernie (Dundee W)
Rowlands, Ted
Roy, Frank
Ruane, Chris
Ruddock, Joan
Russell, Ms Christine (Chester)
Ryan, Ms Joan
Sarwar, Mohammad
Savidge, Malcolm
Sawford, Phil
Sedgemore, Brian
Shaw, Jonathan
Sheerman, Barry
Sheldon, Rt Hon Robert
Simpson, Alan (Nottingham S)
Skinner, Dennis
Smith, Rt Hon Andrew (Oxford E)
Smith, Angela (Basildon)
Smith, Rt Hon Chris (Islington S)
Smith, Jacqui (Redditch)
Smith, John (Glamorgan)
Smith, Llew (Blaenau Gwent)
Snape, Peter
Soley, Clive
Southworth, Ms Helen
Squire, Ms Rachel
Steinberg, Gerry
Stevenson, George
Stewart, David (Inverness E)
Stinchcombe, Paul
Stoate, Dr Howard
Stott, Roger
Strang, Rt Hon Dr Gavin
Straw, Rt Hon Jack
Stringer, Graham
Stuart, Ms Gisela
Sutcliffe, Gerry
Taylor, Rt Hon Mrs Ann
(Dewsbury)
Thomas, Gareth (Clwyd W)
Thomas, Gareth R (Harrow W)
Timms, Stephen
Tipping, Paddy
Touhig, Don
Trickett, Jon
Truswell, Paul
Turner, Dennis (Wolverh'ton SE)
Turner, Dr Desmond (Kemptown)
Turner, Dr George (NW Norfolk)
Twigg, Derek (Halton)
Twigg, Stephen (Enfield)
Vaz, Keith
Walley, Ms Joan
Ward, Ms Claire
Wareing, Robert N
Watts, David
White, Brian
Whitehead, Dr Alan
Wicks, Malcolm
Williams, Rt Hon Alan
(Swansea W)
Williams, Alan W (E Carmarthen)
Williams, Mrs Betty (Conwy)
Wills, Michael
Winnick, David
Winterton, Ms Rosie (Doncaster C)
Wise, Audrey
Wood, Mike
Woolas, Phil
Worthington, Tony
Wright, Anthony D (Gt Yarmouth)
Wright, Dr Tony (Cannock)
Wyatt, Derek

Tellers for the Noes:

Mr. David Jamieson and
Mr. Graham Allen.

Question accordingly negatived.

15 Jun 1999 : Column 234

New Clause 7

Independent review of the incidence of discrimination within the NHS

'.--(1) The Secretary of State shall appoint an independent review to assess the extent of, and make recommendations to end, discrimination by the NHS on the grounds of age, disability, race, sex and sexual orientation in its capacity as--

(a) an employer, and;
(b) a provider of health services.
(2) In subsection (1) "independent" means having a majority of members not employed by the NHS or under the control of the Secretary of State.'.--[Mr. Simon Hughes.]

Brought up, and read the First time.

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