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The noble Baroness said: My Lords, I have already spoken to the amendment. I beg to move.
On Question, amendment agreed to.
Baroness Cumberlege moved Amendments Nos. 31 to 36:
The noble Baroness said: My Lords, I have already spoken to the amendments. I beg to move.
On Question, amendments agreed to.
Baroness Hayman moved Amendment No. 37:
The noble Baroness said: My Lords, the amendment provides for the complaints system available for patients receiving personal medical services or personal dental services under pilot schemes or schemes made permanent under the provisions of the Bill.
The arrangements for complaints are not clear on the face of the Bill. The lines of accountability for doctors, dentists, nurses or others providing services under this legislation are in some doubt. At present there are clear lines of complaint and procedures for complaint either against individual general practitioners, general dental practitioners or health service trusts. It is not certain whether the bodies providing personal medical services or personal dental services under pilot schemes under the legislation would be subject to exactly the same procedures.
The purpose of the amendment is to make clear that patients who receive services under these schemes should have access to complaints procedures that are at least equivalent to those available to patients under conventional schemes.
The amendment is straightforward. The Minister may be able to reassure us that those processes are already in place. However, a simple reading of the Bill does not give that reassurance. The Consumers' Association and the National Consumer Council are most anxious that it should be made explicit that people should not be disadvantaged by being patients of doctors or dentists under these schemes.
The noble Baroness, Lady Miller, was right to say that we have attempted to improve this Bill as it proceeds through the House; it is generally welcomed. However, there is a major issue of contention as regards private companies providing those medical
Having had some experience of dealing with complaints, I do not put forward this argument because I wish to encourage a confrontational attitude between patients and providers, but from the knowledge--I know that it is shared by the Minister--that if one deals properly, sensitively and speedily with complaints one avoids litigation and expense for the National Health Service and distress for patients and complainants. It is an important issue. I look forward to hearing from the Minister. I beg to move.
Baroness Masham of Ilton: My Lords, in recent years there have been many changes in the various complaints procedures. Therefore I agree that one needs great clarification.
Baroness Cumberlege: My Lords, we agree with the noble Baroness that when a patient wishes to complain the procedures must be broadly the same regardless of whether the patient has been treated by, say, a general practitioner working in a pilot scheme or a GP working within the existing system. Patients should feel that they are fully part of the NHS regardless of whether they are treated under the existing or new arrangements.
We intend that the Secretary of State will require standard NHS complaints procedures to be part of the terms of the contracts drawn up between health authorities and boards and providers of services. That way each provider of service, be it general practitioner, general dental practitioner, NHS trust or other body, will have explicitly signed up to the standard complaints arrangements. There may be minor modifications, taking account of the circumstances of each pilot, but overall the arrangements will be on all fours with those which apply now to the family health services and trusts.
Existing NHS complaints procedures do not appear in primary legislation, and nor do we feel that they should do so for pilot arrangements. We are convinced that individual contracts are the appropriate place for stipulating complaints arrangements. We will build on the framework set out by the Bill in discussion with our national consultative groups and, where appropriate, set out more detail in secondary
Baroness Hayman: My Lords, I am grateful to the noble Baroness. Her response appears to cover many of our concerns. I wish to study what she said in detail. In the meantime, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Baroness Cumberlege moved Amendments Nos. 38 to 43:
The noble Baroness said: My Lords, I have already spoken to these amendments. I beg to move.
On Question, amendments agreed to.
Clause 19 [Right to choose medical practitioner]:
Page 11, line 41, after ("participants") insert ("other than Health Authorities").
Page 12, line 12, at end insert--
("(ee) prevent (except in such circumstances and to such extent as may be prescribed) a medical practitioner who performs personal medical services in accordance with section 28C arrangements from providing general medical services;").
Page 12, line 21, leave out from ("for") to end of line 26 and insert ("directions, as to payments, made under section 4(7) of the Act of 1990 (as it has effect as a result of regulations made by virtue of paragraph (g)) to be enforceable in a county court (if the court so orders) as if they were judgments or orders of that court;").
Page 12, line 26, at end insert--
("(hh) confer powers or impose duties on the Dental Practice Board in relation to agreements made by virtue of section 28C(1) under which personal dental services are provided;").
Page 12, line 34, at end insert--
("( ) Regulations made by virtue of subsection (3)(f) may, in particular, include provision--
(a) requiring (except in prescribed circumstances) Health Authorities to remove from their medical lists persons who are performing personal medical services in accordance with section 28C arrangements;
(b) conferring a right to transfer to a medical list on persons who have ceased to perform such services;
(c) that any provision in relation to medical lists made by or under any enactment is not to apply;
(d) as to conditions to be attached to entries in medical lists;
(e) conferring powers of disqualification on the Tribunal constituted under section 46.").
Page 12, line 34, at end insert--
("( ) The power to make provision under this section of the kind mentioned in subsection (3)(hh) includes power--
(a) to authorise or require the Dental Practice Board to perform on behalf of a Health Authority functions of a prescribed description (including functions relating to remuneration) which have been delegated to the Board by the Health Authority in accordance with a power conferred by the regulations;
(b) to provide that functions conferred by the regulations are only to be exercised by the Board in accordance with directions of the Secretary of State;
(c) to require information for the purpose of performing any functions conferred or imposed on the Board under this section.").
Page 12, line 43, after ("participants") insert ("other than Health Boards").
Page 12, line 49, at end insert--
"(c) include the provision of a complaints system for patients which is equivalent to that required of general medical and general dental practitioners").
Page 13, line 13, at end insert--
("(ee) prevent (except in such circumstances and to such extent as may be prescribed) a medical practitioner who performs personal medical services in accordance with section 17C arrangements from providing general medical services;").
Page 13, line 21, leave out from ("for") to end of line 25 and insert ("directions, as to payments, made under section 17A(8) (as it has effect as a result of regulations made by virtue of paragraph (g)) to be enforceable by the sheriff as if they were judgments or orders of the sheriff and whether or not the sheriff could himself have made such judgments or orders;").
Page 13, line 25, at end insert--
("(hh) confer powers or impose duties on the Dental Practice Board in relation to agreements made by virtue of section 17C(1) under which personal dental services are provided;").
Page 13, line 33, at end insert--
("( ) Regulations made by virtue of subsection (3)(f) may, in particular, include provision--
(a) requiring (except in prescribed circumstances) Health Boards to remove from their medical lists persons who are performing personal medical services in accordance with section 17C arrangements;
(b) conferring a right to transfer to a medical list on persons who have ceased to perform such services;
(c) that any provision in relation to medical lists made by or under any enactment is not to apply;
(d) as to conditions to be attached to entries in medical lists;
(e) conferring powers of disqualification on the Tribunal constituted under section 29.").
Page 13, line 33, at end insert--
("( ) The power to make provision under this section of the kind mentioned in subsection (3)(hh) includes power--
(a) to authorise or require the Dental Practice Board to perform on behalf of a Health Board functions of a prescribed description (including functions relating to remuneration) which have been delegated to the Dental Practice Board by the Health Board in accordance with a power conferred by the regulations;
(b) to provide that functions conferred by the regulations are only to be exercised by the Dental Practice Board in accordance with directions of the Secretary of State;
(c) to require information for the purpose of performing any functions conferred or imposed on the Dental Practice Board under this section.").
Page 13, line 34, leave out first ("section") and insert ("Act").
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