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Liability to Pay NHS Charges

The Minister of State, Department of Health (Ms Rosie Winterton): I beg to move amendment No. 235, in page 61, line 36, after 'injury' insert


', whether physical or psychological,'.

Mr. Deputy Speaker (Sir Michael Lord): With this it will be convenient to discuss the following:Government amendments Nos. 236 and 237.

Amendment No. 29, in page 63, line 15, at end insert—


'(9A) No regulations may be made by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

Government amendment No. 238.

Amendment No. 30, in clause 144, page 67, line 22, at end insert—


'(11) No regulations may be made under by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

Government amendment No. 239.

Amendment No. 31, in clause 148, page 71, line 22, at end insert—


'(8) No regulations may be made by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

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Government amendment No. 240.

Amendment No. 32, in clause 151, page 73, line 22, at end insert—


'(3A) No regulations may be made by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

Amendment No. 33, in clause 153, page 75, line 21, at end insert—


'(3A) No regulations may be made by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

Amendment No. 34, in clause 154, page 76, line 23, at end insert—


'(4) No regulations may be made by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

Amendment No. 35, in clause 155, page 76, line 40, at end insert—


'(4A) No regulations may be made by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

Government amendment No. 241.

Amendment No. 36, in clause 156, page 77, line 16, at end insert—


'(1A) No regulations may be made by the Secretary of State under this section unless a draft of the regulations has been laid before Parliament and approved by a resolution of each House.'.

Amendment No. 37, in clause 181, page 95, line 35, after 'from', insert


'regulations under sections 141, 144, 148, 151 or 153 to 156 or'.

Ms Winterton: This part of the Bill was discussed in some depth in Committee. I hope that I will be able to show that the Government have listened and have responded positively to the concerns raised.

Government amendments Nos. 235, 236 and 237 amend clause 141 and are intended to put an end to any concerns about the scope of the NHS costs recovery scheme. Our policy intention in relation to the scope of the NHS costs recovery scheme has always been clear. As my right hon. Friend the Minister of State said when this was discussed in Committee, free-standing diseases, particularly industrial diseases, are not covered by the scheme. It is our intention that both physical and psychological injury are covered. Nevertheless, some Committee members expressed genuine concerns about whether the Bill as then drafted left room for other interpretations, and my right hon. Friend agreed to reconsider the issue. We have decided to put the matter beyond doubt and the amendments seek to achieve that.

Government amendment No. 235 confirms that psychological injury as well as physical injury is included in the scheme. That would cover, for example, the case of someone who received NHS treatment for post-traumatic stress disorder following a particularly harrowing incident for which they received compensation. The compensator would also be liable for NHS charges relating to the treatment.

Government amendment No. 237 deals with questions that arose on the issue of disease itself. It makes it clear that free-standing disease, which would include, for example, asbestosis or mesothelioma, will

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not be within the scope of the scheme. There will be cases in which someone suffers an injury that leads to the development of a disease as a consequence of the injury. An example might be someone who suffers a broken leg that becomes infected and results in septicaemia. In such cases, if the disease is directly attributable to the original injury, it is clearly right that treatment of it should be included as part of the overall treatment of the injury for costs recovery purposes. The amendment makes that distinction clear.

Dr. Evan Harris: Committee members asked how that arrangement would work, even in a policy that we did not particularly like. I am grateful that the Government have tabled an amendment to clarify that. The remaining problem is whose decision it is, and on what basis they decide, that the disease in question is attributable to the injury suffered. One can usually tell when an injury is caused by an incident, and that would be covered. It is much harder to say whether a disease is attributable to an injury. Has the Minister given any thought to how that might be decided?

Ms Winterton: Obviously, such cases would be linked to decisions made about personal injury claims, and there are two ways in which the decision might be forthcoming. One way would be through a court case where that had been established, and secondly, where an insurance company was settling a claim, there would be discussion about that and agreement would be reached. Clearly, if that gave rise to an appeal, the mechanism to deal with it exists.

Government amendment No. 236 is the first of five minor drafting changes. Government amendment No. 237 specifies that only disease attributable to an injury should be taken into account for the recovery scheme, on the basis that treatment for such a disease is received as a result of the injury. Having used the words "as a result" in that amendment, we have been advised that the same wording should be used in clause 141 (1)(b)(i) and at various other places in this part of the Bill, in place of the original reference to treatment "in respect" of the injury. That ensures clarity and consistency in the test to be used in assessing whether treatment received is within the scope of the scheme. Government amendment No. 236 is the first of those technical changes.

Opposition amendment No.29 seeks to amend clause 141 by making the regulation-making powers in that clause subject to the affirmative resolution procedure. Indeed, all the Opposition amendments—Nos. 29 to 37—try to do the same thing.

With only one or two exceptions, the regulation-making powers in part 3 are not new. Rather, they mirror—sometimes word for word—powers that already exist in the Road Traffic (NHS) Charges Act 1999. Regulations made under the terms of that Act are all subject to the negative resolution procedure, and I see no reason why regulations made under the Bill, which will largely be concerned with the detailed and technical administration of the scheme, should be treated any differently.

Mr. Burns: The Minister sees no reason why regulations made under the Bill should be treated any

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differently. Why does she think the original decision was taken to use the negative, not the affirmative, resolution procedure?

Ms Winterton: For reasons of consistency, which we believe should continue in the Bill. The regulation-making powers are concerned largely with the administration of the scheme, and we believe that the time of the House would be better spent dealing with them through negative rather than affirmative resolution, especially as all the regulations are set out. I appreciate that the Opposition would prefer regulations to be made by affirmative resolution, but given the amount of time available to the House to discuss such matters, we believe that the negative procedure will be sufficient. Of course, the Opposition are free to pray against those regulations if they wish to do so.

Government amendment No. 238 is one of a small number of minor technical drafting amendments, like amendment No. 236 which I have already covered, consequential on the wording of amendment No. 237. The intention is simply to ensure that references are consistent throughout this part of the Bill. Government amendment No. 239 is another minor drafting amendment consequential on the wording of amendment No. 237, as is Government amendment No. 240. Government amendment No. 241 is the last of the minor amendments designed to ensure consistency.

7. 45 pm

I hope that hon. Members will accept that the Government amendments have been tabled in response to concerns raised in Committee and are intended to clarify the position, or are largely technical. I hope that hon. Members will also accept that the Opposition amendments are not only unnecessary, but would take up valuable time of the House, particularly when they repeat what already exists in legislation. I ask the House to accept the Government amendments and reject those of the Opposition.


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