Health Bill


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Mrs. Dorries: Would it not be simpler for PCTs if the Minister found a way for the Bill to say that they would, in effect, carry out just the administrative process—that every ophthalmic practitioner who provides services to the eligible population will continue to do so in the same way? The Minister has not clarified that sufficiently. The PCT would merely carry out the administrative process in the same way as currently happens from a central location; there would be no cash limitation and no limitation on budgets, and funds would go to the same practitioners as previously; there would be no change in service delivery and accessibility for patients and service users, and no change for service providers; there would just be an administrative process.

Dr. Murrison: I am grateful to my hon. Friend for her remarks. She highlights an important point in
 
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asking whether there is potential for Ministers to meddle. My answer was that the case for the change is not proven. Our position this morning has been that the range of services is actually well provided and access is of high quality, as evidenced by the complaints figures, which I have already highlighted twice. Every element of the service appears to be functioning reasonably well and providers seem to be happy with it, although improvements can always be made around the edges. Yet here is a sledgehammer of seven clauses bolted on to an inelegant Bill, to address a problem that appears to be more or less a figment of the Government's imagination and for which they are scrabbling round to try to find justification.

We shall support everything that the Minister does to improve quality and access to health services for constituents, but we are not keen on chasing down a rabbit hole after a non-existent problem—which, in all candour, is precisely what it appears to be. The Minister's references to fraud show that she is scratching around to find a rationale for the provisions, yet we have not heard sufficient justification of the costs involved, despite the fact that, contrary to what she has said, costs are a relevant consideration in the context of the amendments.

It may not be profitable for me to pursue the issues of audit and inspection any further, but surely the Minister can see that if she insists on imposing contractual arrangements between elements of the NHS and individuals where at present there are none, and on subjecting them to audit, inspection, quality control or whatever one calls it, there will be an onus on contracting parties to ensure that the quality level goes beyond writing down a list of practitioners and keeping it in a dusty office.

I suspect that that would be the case in law, because there may be arguments of vicarious liability in the unlikely event of an individual deciding that he or she was unhappy with a particular service and saying to the PCT, ''Look, you certified this practice as a good one and you gave it a contract and a seal of approval, and it has let me down, so I'm complaining about you as much as about the individuals who gave me the service.'' Unlike the hon. Member for Stafford (Mr. Kidney), I am not—fortunately—blessed with being a lawyer, but I suspect that that would be the case in law. I expect that there will have to be an increase in the audit and inspection regime as a result of these seven clauses.

It being One o'clock, The Chairman adjourned the Committee without Question put, pursuant to the Standing Order.

Adjourned till this day at five minutes to Four o'clock.

 
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