Jane Kennedy: We are discussing the narrow focus of clause 32. When determining chemist applications to provide pharmaceutical services, current legislation means that PCTs cannot take into account additional services that the chemist might offer.
When PCTs are looking at competing applications that relate to the same neighbourhood and which individually pass the necessary or desirable tests, clause
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32 will allow them to consider the improvements that each chemist would bring to the provision of over-the-counter medicines and other health care products, as well as associated advice.
Our proposal aims to encourage applicants to offer improvements generally to the range and availability of medicines and services to support self-care; for example, through helping people to manage minor ailments and promoting healthier living through better advice and information about such products. The hon. Member for Romsey (Sandra Gidley) expressed concern that smaller businesses might not be able to fend off bigger competitors. She also argued that the clause was not sustainable or workable.
I do not share the hon. Lady's pessimismor if I did, I would not be proposing the measure. The important point is that although the price of over-the-counter medicines must obviously be a factor, the clause is not simply about price; to a large degree, it is about support and advice to the patient in the management of such medicines.
Sandra Gidley: I understand the possible drivers for persuading applicants to offer extra services, which must be a good thing for patients. However, it is difficult to balance the offer of a low price on medicines against those other services. The consideration should not be purely financial. Although the provision of other services is worthy and could benefit the local health economy, merely to consider the price of medicines seems a step too far.
Jane Kennedy: I hear what the hon. Lady says, but her amendment would prevent PCTs from considering what improvements applicants would bring to the provision of over-the-counter medicines in certain cases, which is specific and narrow. Instead, PCTs would be limited to considering only the provision of advice and a range of other health care products, such as dressings, incontinence appliances or sunscreens. That is important and would be welcomed by everybody, but I do not accept the concerns expressed by the hon. Lady, so I hope that the amendment is a probing one. I appreciate that we are on Report, but there may be further opportunity to consider the matter in another place.
The clause is in line with our policy of opening up and developing community pharmacy services. It will improve the availability of over-the-counter medicines in deprived communities. I hope that the amendment was a probing one and I ask the hon. Lady not to press it to a vote. I will consider her comments and perhaps I can respond at a later date.
Sandra Gidley: I am disappointed that the Minister did not even give us a hint about how the clause will be enforced. As I pointed out, it is unenforceable. If pharmacies decide to change the services that they offer, which may be down to financial constraints, it is difficult to see what teeth the PCT will have. Somebody could promise the earth to secure a contract, but not deliver, and the patient would be the poorer.
It is disappointing that the Minister has not given us any commitments and that she has not said that she will review how the measure works in practice, given the
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concerns that have been expressed. I shall not divide the House on a technical matter, but I hope that it will be revisited in another place and that the Minister will write to me with reassurances about the points that I have raised.
Dr. Murrison: I will not press the amendment to a vote but very much hope that we will find ourselves in violent agreement with the Government, who have consistently made it clear in Committee and during today's proceedings that they favour the affirmative procedure in respect of regulations, which flow like the Tiber through the Bill. Amendments Nos. 33 and 34 would simply ensure that the affirmative procedure would be applied to clause 5, which clearly deals with vehicles, and clause 2, in respect of which we are particularly concerned about the definitions of what is enclosed, substantially enclosed, not enclosed and so on. The Minister must agree that it is important, given the uncertainly that surrounds such things, that the regulations that the Secretary of State may wish to enforce are subject to the affirmative procedure.
Caroline Flint: As the hon. Gentleman suggests, under amendments Nos. 33 and 34, regulations made under clauses 2 and 5 would be subject to the affirmative procedure. Clause 2 makes provision for premises open to the public and those used for work to be smoke-free. It applies only to premises that are enclosed or substantially enclosed and enables regulations to be made to define the meaning of the words "enclosed" and "substantially enclosed". Meanwhile, clause 5 enables regulations to be made to provide for vehicles to be smoke-free.
Those matters have been left to regulations to enable consultation with stakeholders and to allow flexibility to amend requirements if need be, based on practical post-implementation experience without the need to amend primary legislation. Given the possibly technical nature of the regulations that would be made under clauses 2 and 5, we have undertaken to conduct a public consultation exercise with respect to any draft regulation prepared.
The negative procedure was selected for the exercise of those powers, as we felt that Parliament would have no good reason in particular to consider such highly technical matters in such detail that it would warrant taking the affirmative route. However, we discussed such issues in Committee, and I said that I would
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consider them. The hon. Gentleman has again expressed his wish for the affirmative procedure to be used, and I will listen to the views of the Delegated Powers and Regulatory Reform Committee of the other place when it comes to scrutinise the Bill. On that basis, I cannot support the amendment but remain of an open mind and open to persuasion.
Dr. Murrison: I am grateful to the Minister for clearly pointing out that these matters will be considered in another place. I hope very much that their lordships will listen to what has been said in Committee and today and will propose amendments that would have the effect that I desire, but given the Minister's assurances that she is still thinking about the issue, I beg to ask leave to withdraw the amendment.
In Schedule 1 to the Health and Social Care Act 2001 (exempt information relating to health services), for paragraph 11(a) (as substituted by paragraph 72(2) of Schedule 11 to the 2003 Act) substitute