Health and Social Care (Community Health and Standards) Bill

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Mr. Burns: I am grateful to the Minister for assuring us that he will look again at the issues thrown up by the amendments. I put on record that I fully understand that by having a look at the amendments, the Minister is making no commitments; he may change his intentions.

Mr. Hutton: I am grateful to the hon. Gentleman for making that clear. That is the case, and I have expressed my preference.

With your indulgence, Mr. Atkinson, I wish to deal with a point raised by the hon. Member for Westbury. He asked who would carry out this function. An important aspect of the Bill is that, for the first time, general dental service practitioners will be allowed to

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be involved in oral public health provision. I hope that that the hon. Gentleman, and other hon. Members, welcome that change.

Mr. Burns: In light of the Minister's comments, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

10.45 am

Question proposed, That the clause stand part of the Bill

Dr. Harris: In contrast to clause 158, subsections (5) and (6) of new section 16CA contained in clause 157 specifically provide for regulations, their purpose and scope. New section 16CB contained in clause 158 mentions prescribed functions in subsections (1), (2) and (3), but does not mention where the regulations that set out those functions are, or where the regulation-making power is. I assume that the Government are relying on a general regulation-making power somewhere in this part of the Bill, and perhaps there is a general provision in the Bill. I looked for it, but could not find it.

Given that the issues are similar—indeed, we have just debated what dental public services should provide—why does new section 16CB not include descriptive subsections about regulations equivalent to those subsections included in new section 16CA? New section 16CA(6) mentions ''the manner or circumstances'' in which some of the dental public health services might be provided. I hope that my question is clear, and that the Minister can answer it; if not now, then later.

Mr. Hutton: It is important to bear in mind that all those amendments are insertions into the 1977 legislation. In this case, I understand that the regulation-making power is contained in the 1977 Act. The Secretary of State—or, where appropriate, the National Assembly for Wales—has the power to make those regulations.

Dr. Harris: I know that there are general regulation-making powers in this Bill and in the 1977 Act. Why has specific provision been made for regulations in new section 16CA but not in new section 16CB? Presumably such provision was not felt necessary, or perhaps it is redundant in new section 16CA. When a subsection mentions functions that may be prescribed, I check whether there is anything specific about the regulation-making power. The Government are not generally reluctant to give themselves specific regulation-making powers and descriptions of how those regulations are provided for. Why the distinction in the treatment of the two areas?

Mr. Hutton: It relates to the specific circumstances of the two different duties. Subsection (6) of new section 16CA has been included because we want it to cover that ground. I gave an example of weekday services and the hours in which they are provided. Section 128 of the 1977 Act sets out a general regulation-making power, and I am confident that the powers to make regulations under the 1977 Act give us the necessary flexibility and reach. We included new section 16CA(6) because we did not have that power, and we feel that we were right to include it.

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Dr. Harris: On that basis, will the Minister consider whether—if he did not feel that the general powers were sufficient to provide for those proposed in section 16CA(6)—there are similar issues relating to the manner and circumstances by which dental public health services are provided, such as those listed in the amendments we have just discussed? If he agrees that there are, will he consider including equivalent regulation-making powers or qualifications to section 16CA(6) in clause 158, so that we can be certain that there will be the ability to make regulations that will

    ''describe services by reference to the manner or circumstances in which they are provided.''?

That is even more important in the provision of some of these services than in terms of primary dental services.

Mr. Hutton: I am confident that we have sufficient flexibility under section 128 of the National Health Act 1977, but I assure the hon. Gentleman that we will have another look at it.

Question put and agreed to.

Clause 158 ordered to stand part of the Bill.

Clause 159

General dental services contracts

Mr. Hutton: I beg to move amendment No. 616, in

    clause 159, page 76, line 25, leave out from 'professional' to 'services' in line 26 and insert

    'who is engaged in the provision of'.

The Chairman: With this it will be convenient to discuss the following:

Government amendments Nos. 617 to 620.

Mr. Hutton: The amendments make minor and technical changes to section 28M of the National Health Act 1977, ''Persons eligible to enter into GDS contracts''; in particular to the conditions that are to apply to those who may become contractors under a GDS contract.

General dental services may be provided by a dental practitioner, a dental corporation or a partnership including at least one dental practitioner, and any of those people listed in section 28M(2)(b)(i) to (iii). Amendment No. 616 changes the wording of section 28M(2)(b)(iii) to make clear that health care professionals who work for the health service in any capacity are eligible to seek GDS contracts as a member of such a partnership. The existing wording might have implied that they had to have a contract to provide services in the health service when, in fact, it does not matter whether they are working for the health service as employees, contractors or on any other basis. The important point is that they are engaged in providing services for the health service. That was always our intention and I hope that is now put beyond all doubt.

The amendments would add existing providers under a GDS or PDS contract to the list of potential providers of GDS contracts. Otherwise, it is possible that providers—such as practice managers, who are parties to GDS contracts—would not be able to seek

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new contracts because they may not fall into any of the existing categories. We want to avoid that situation.

The amendment also makes provision to cover the situation where a person, such as a practice manager, was a provider of GDS, but that contract terminated before a new contract was agreed. The exercise of the power will allow such a person to enter into a new contract for a prescribed period—for example, three or four months or longer—after the ending of the first contract. That is notwithstanding the fact that he is not currently a provider, and is simply an avoidance of that provision.

Amendment No. 617 enables regulations to cover the situation where there is a change in a partnership whose members hold a GDS contract; for example, where one of the partners leaves or a new partner joins the practice. It is intended to avoid an unnecessary renegotiation of the contract.

Amendment No. 618 alters the definition of a dental corporation in line with that which appears elsewhere in the 1977 Act. That was an oversight. The purpose of amendment No. 620 is to adjust the definition of an NHS employee in relation to a GDS contract to ensure consistency with the same definition that applies in relation to primary dental services.

Amendment agreed to.

Amendments made: No. 617, in

    clause 159, page 76, line 27, at end insert


    (iv) an individual who is providing services under a general dental services contract or in accordance with section 28C arrangements or arrangements under section 17C of the National Health Service (Scotland) Act 1978, or has so provided them within such period as may be prescribed.'.

No. 618, in

    clause 159, page 76, line 27, at end insert—

    '( ) Regulations may make provision as to the effect, in relation to a general dental services contract entered into by individuals practising in partnership, of a change in the membership of the partnership.'.

No. 619, in

    clause 159, page 76, line 29, leave out from 'which' to end of line 31 and insert

    ', in accordance with the provisions of Part 4 of the Dentists Act 1984, is entitled to carry on the business of dentistry'.

No. 620, in

    clause 159, page 76, line 37, after 'NHS employee' insert

    'has the same meaning as it has in section 28D above in the case of an agreement under which primary dental services are provided; and'.—[Mr. Hutton.]

Clause 159, as amended, ordered to stand part of the Bill.

Clause 160

General dental services: transitional

Question proposed, That the clause stand part of the Bill.

Mr. Burns: The effect of clause 160 is to set out the transitional arrangements for general dental services.

The clause gives the Government powers to make orders to ensure a smooth transitional period between

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the systems. The orders are significant in their own right, giving opportunities for discussions on how the transitional arrangements are being organised and on the future system of dental services; all of them will be made under the negative procedures.

I shall not rehearse my arguments about the pros and cons of affirmative rather than negative resolutions again because the Minister has heard those arguments many times in various Committees in recent years. Those arguments, with which he is familiar, still hold good. However, given the importance of those orders and what they will do, will the Minister reconsider and make the orders subject to affirmative rather than negative resolutions, so that, when they are made, Parliament will have the opportunity to debate in detail the Government's proposals to ensure that they are getting it right?

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