Health Bill


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Caroline Flint: I beg to move amendment No. 112, in clause 38, page 35, line 10, leave out from 'determine' to end of line 22 and insert

    'the amount of its administrative expenses for that year.

    ( ) A Primary Care Trust may—

 
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      (a) on the request of a committee recognised by it, allot to that committee such sums as it may determine for defraying the committee's administrative expenses; and'.

    The Chairman: With this it will be convenient to consider Government amendment No. 113.

    Caroline Flint: These two amendments seek to ensure that local optical committees are representative of both local providers and performers by providing a simpler arrangement for the committee. The only money available in general ophthalmic services are the fees paid by primary care trusts for the services for which they contract. Those fees may be paid only to contractors and are not paid direct to performers. As local optical committees are to be representative of both providers and performers of primary ophthalmic services, it seems only right that the fees paid for the provision of the services should meet the total expenses of running the committee.

    Requiring performers to make a separate payment would almost certainly be a disincentive to being involved in the local optical committee, which would make it less representative and may lead to primary care trusts not recognising such committees. Therefore, a simple levy against the fees paid is in our view the right approach. It will be simply and easily administered and will help to ensure that local optical committees are representative of performers as well as providers. It continues the present arrangements for funding these committees and therefore I hope that hon. Members will support the amendments.

    Dr. Murrison: This is fairly straightforward, but I should be grateful if the Minister told us the anticipated level of the levy. She has assured us that it would not be particularly high, but it would be useful to know what it might be approximately. Presumably, there are parallels with other committees to which she referred earlier.

    Caroline Flint: I do not have those figures to hand, but I can assure the hon. Gentleman that we would want to see that the levy was proportionate and not over-expensive. I will write to him with further information about that.

    Amendment agreed to.

    Amendment made: No. 113, in clause 38, page 35, leave out lines 27 to 32.—[Caroline Flint.]

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

    Dr. Murrison: This is a largely uncontroversial clause, so I shall not detain the Committee long on it. It would be good to know what the Minister's intentions are in respect of the function of the committees. I am sure that it is necessary, and common sense suggests that it will not be hugely burdensome on the profession, or the public purse for that matter. However, it would be useful to know exactly what it will achieve.

    We have remonstrated with the Minister up to this point about the lack of the review that we were promised. Undoubtedly, the fact that we have not had that review has meant that there have been several holes in this area of debate and several things left
     
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    unanswered. I suspect that the local optical committees will have a fair amount of work to do in interpreting the Bill and carrying forward its provisions. In particular, the committees may consider things such as enhanced and additional services, which we have not heard a huge amount about in the debate. It is not referred to directly in the Bill or the guidance notes that go with it, but it is referred to in the briefing documents that we received from the profession on the back of discussions that the profession had with Ministers.

    I assume that the provision of additional and enhanced services, some of which we have discussed, broadly speaking, would be the stuff of the local optical committees. They would be proactive in making recommendations to the PCT on how its members could improve the health of the PCT's patient base. It would be useful to hear the Minister's thoughts on that, as well as a little more description of exactly what she envisages local optical committees doing.

    Caroline Flint: There is not much that I can add to what I said earlier, which is that the committee would mirror similar committees that are provided for other local services, in that it would form a body of people whom the PCT could consult on a range of issues. As I suggested, those issues could include cases where the PCT wants support in helping providers in different ways. That was covered by an earlier clause. The issues could be about the particular eye health needs of the community, and about sharing information about the changes happening locally with providers and performers.

    As I have said, a review is ongoing, and that review addresses what secondary care could be provided in a primary care setting. I imagine that PCTs, in putting their views across to Government, may want to discuss that with others in future. I am sure that that debate will develop over time. I hope that that gives the hon. Gentleman some idea of what we are talking about, but obviously it is difficult to just pull out a list. The committees will not just receive information, I hasten to add; they will be a vehicle for their members to share their expertise, experience and knowledge with the PCT. That will ensure that the sight testing policy, which is centrally funded, and for which the PCT is reimbursed, is working properly. Also, the committees will form part of a discussion about enhanced services.

    I do not have the figures for the cost at the moment, but I expect that it will be very low. We are talking about the expenses of the committee, of hiring rooms for meetings and, my officials suggest, of tea and biscuits—we had better knock that off, because that is not very necessary. Is it healthy? Perhaps we should say a plate of fruit instead. We are not talking about a tier of administrative support. The committee is an identified body that can act as a formal sounding board that the PCT can engage in discussion, so that it feels that it has a greater understanding of what is happening in the local area in terms of health needs and other issues. I hope that that reassures the hon. Gentleman.

    Question put and agreed to.
     
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    Clause 38, as amended, ordered to stand part of the Bill.

    Clause 39

    Payments in respect of optical appliances

    Stephen Williams: I beg to move amendment No. 80, in clause 39, page 36, line 7, at end insert—

      '( ) A description set out under subsection (2) shall include any person unqualified to dispense optical appliances to persons under the age of 16.'.

    The Chairman: With this it will be convenient to discuss amendment No. 119, in clause 39, page 36, line 7, at end insert

      'which may include persons unqualified to dispense optical appliances to persons under the age of 16.'.

    Stephen Williams: The clause is to be welcomed. We have heard several references today to the need to address fraud in the system, although there have been disputes about the extent of that fraud. The clause is a welcome step towards making sure that PCTs have added powers to put checks in place to make sure that the voucher system is not abused in any way. We have heard from the hon. Member for Mid-Bedfordshire, who has on display an array of spectacles from a variety of outlets. I am sure that they are all bona fide outlets, but I understand that the profession has concerns about unscrupulous providers who may abuse the system, particularly in relation to spectacles that may be bought over the internet.

    The purpose of the amendment is to strengthen the clause slightly to make it clear that the only people who are allowed to dispense spectacles to children are optometrists, qualified ophthalmic dispensers and doctors. That builds in a further safeguard that would not only protect children's health, but make sure that the voucher system—it is frequently children who have vouchers for glasses—is not open to further abuse. That is the purpose of the amendment.

    5.45 pm

    Caroline Flint: The amendments are alternatives, both of which seek to restrict to registered opticians or medical practitioners those who might receive payment for the supply, repair or replacement of optical appliances. Amendment No. 80 seeks to make it mandatory and amendment No. 119 would create a regulation-making power. I support the hon. Gentleman's general intention. We are committed to ensuring that payments for optical appliances are made appropriately when work has been carried out properly and legally. The law already requires that sales of optical appliances for children and most such sales to adults be made under the supervision of a registered optician or medical practitioner. Our view is that the supervision of sales of optical appliances by a registered dispensing optician, optometrist or medical practitioner offers adequate protection.

    As we discussed earlier, businesses might be owned by people who are not members of one of those three clinical professions. So long as they employ qualified professionals to supervise sales, those sales are proper and optical vouchers may be used to make the purchases. I therefore suggest that amendments Nos. 80 and 119 be rejected. However, I understand the
     
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    concern, which has been rightly voiced, that we should reconfirm the importance of ensuring that qualified practitioners are involved in the sale of those accessories.

    Stephen Williams: I have listened carefully to the Minister. She was fairly conciliatory, so I beg to ask leave to withdraw the amendment.

    Amendment, by leave, withdrawn.

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

    Caroline Flint: We intend to make it a condition of receiving payments for optical vouchers that individuals or companies make available records relating to the transaction when required to do so by a PCT. Failure to comply with that condition would be sufficient reason for a PCT to refuse to make payments, as it could give grounds for concern that the money could not be accounted for and that there was, therefore, a clear risk that public funds were being misused. That is an important aspect of ensuring that the vouchers are used in a way that is above board and that the scheme is implemented properly.

    Question put and agreed to.

    Clause 39 ordered to stand part of the Bill.

     
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