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Mr. Swayne: The Minister asked if I was opposed in principle to accreditation. In my opening remarks, I sought to make it absolutely clear that we are in favour of that. We support the principle behind the clause. Our concern is that the regulations might be used to enforce access to all out-of-hours services via NHS Direct, which we do not believe is yet sufficiently robust to bear that burden. Mr. Denham: I have dealt briefly with the strategy that we would prefer to follow in order to convince people, and I believe that we will achieve our objective. The resolution of practitioners at the BMA last year about investing £80 million in their premises provoked some amusement. At our last sitting, we discussed the investment of £8,000 million in the premises of GPs, so clearly we are meeting that aspiration of the medical profession. Regarding nurse-led practices, the responsibility for out-of-hours provision clearly lies with the GP, as does the rest of the service. However, there is no bar to nurse-led practices—PMS practices—becoming accredited providers, provided that they meet the standards set out in the regulations. Dr. Brand: The Minister did not respond to my specific question about whether rotas for GPs who intend to retain 24-hour responsibility will be caught by the regulatory mechanism. Mr. Denham: I had intended to answer the hon. Gentleman's question. It does not matter whether the service is provided by rotas. If it is an out-of-hours service, it has to be accredited under the regulations. The quality of the service offered to the patient must be consistent. Dr. Brand: If a husband and wife team look after a practice population 90 per cent. of the time, will they have to apply for accreditation in order to have an arrangement about who gets up at night? Mr. Denham: The issue is whether someone delegates responsibility to another provider. If that is unclear, I will write to the hon. Gentleman. We must ensure that we have consistent standards across the service. That should be a part of any arrangements that are put into place. There will be some challenges to the traditional provider or practice, but if there is no delegation—the individual is offering a 24-hour service as stated in his or her contract—there will be no accreditation requirement. Question put and agreed to. Clause 21 ordered to stand part of the Bill. Further consideration adjourned.—[Mr. Jamieson.] Adjourned accordingly at twenty-four minutes past Eleven o'clock till this day at half-past Two o'clock.
The following Members attended the Committee:
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| Prepared 25 January 2001 | |
