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Baroness Miller of Hendon moved Amendment No. 60:
The noble Baroness said: My Lords, in moving this amendment I shall speak also to Amendments Nos. 61, 62, 63 and 89. Since the inception of the National Health Service it has been unlawful to sell the goodwill of a medical practice. The Bill extends the prohibition to all those involved in providing and delivering personal medical services. Our aim is simply to ensure that the extension of the prohibition is done in a fair and even-handed way.
Amendments Nos. 60, 61, 62, 63 and 89 that we placed before the House are minor and consequential and are intended to ensure that our aim to extend the goodwill prohibition fairly to those who provide and deliver personal medical services is fully met. I very much hope that your Lordships will support the amendments. I beg to move.
Baroness Jay of Paddington: My Lords, two of the amendments are in my name. They relate to a question which the noble Baroness has not addressed; namely, the difference in this legislation between the sale of goodwill, to which we understand the provisions are addressed, and the previous legislation in which the words "partial goodwill" were also used. There is some concern that in a sense this may disguise an area about partial sale of assets within a general practice or within any kind of practice set up under the pilot schemes. The words "any part of goodwill" as opposed to "goodwill" in general, would make it more comfortable for those who are concerned about the implications of removing that provision. Perhaps the Minister can help me with that point.
Baroness Miller of Hendon: My Lords, I do not think the amendment will have the intention that the noble Baroness supposed. But we shall take it back and look at it with our officials.
On Question, amendment agreed to.
Baroness Cumberlege moved Amendment No. 61:
On Question, amendment agreed to.
Baroness Cumberlege moved Amendment No. 62:
On Question, amendment agreed to.
Baroness Cumberlege moved Amendment No. 63:
On Question, amendment agreed to.
Baroness Cumberlege moved Amendment No. 64:
Page 27, line 11, at beginning insert ("provided or").
Page 27, line 23, leave out from ("Authority") to end of line 25 and insert ("by arrangement with whom a person has at any time--
(a) provided general medical services, or
(b) provided or performed personal medical services in accordance with section 28C arrangements,
means the area, district or locality of that Council, Committee or Authority (at that time).").
Page 27, line 36, at beginning insert ("provided or").
Page 28, line 2, leave out from ("Board") to end of line 3 and insert ("by arrangement with whom a person has at any time--
(a) provided general medical services, or
(b) provided or performed personal medical services in accordance with section 17C arrangements,
means the area of that Council or Board (at that time).").
After Clause 30, insert the following new clause--
(".--(1) In section 85 of the 1978 Act (expenses of certain bodies), after subsection (1) insert--
"(1AA) Notwithstanding subsection (2), the amount allotted by the Secretary of State to a Health Board under subsection (1) shall include provision for expenditure of that Board which is attributable to--
(a) remuneration which is paid to persons providing additional pharmaceutical services (in accordance with directions under section 27A), in respect of such of those services as are designated; or
(b) remuneration which is--
(i) paid to persons providing general medical services under Part II;
(ii) determined by the Health Board concerned; and
(iii) of a designated description.
(1AB) In subsection (1AA), "designated" means designated in writing by the Secretary of State for the purposes of that subsection and in relation to the allotment in question.".
(2) In subsection (2) at the beginning insert "Subject to subsection (1AA),".").
The noble Baroness said: My Lords, this new clause permits health boards to make payments from cash limited funds to GPs with whom they agree to develop specific areas of general medical services locally and to persons who undertake to provide certain additional pharmaceutical services. The clause is the Scottish equivalent of the English provisions contained in Clause 30(3A)(c) and (d) of the Bill. I commend it to the House. I beg to move.
On Question, amendment agreed to.
Baroness Cumberlege moved Amendment No. 65:
The noble Baroness said: My Lords, I have already spoken to this amendment with Amendment No. 10. I beg to move.
On Question, amendment agreed to.
Clause 34 [Short title, commencement and extent, etc.]:
Lord Rea moved Amendment No. 66:
The noble Lord said: My Lords, the purpose of the amendment is to introduce the word "Health" into the Short Title of the Bill between the words "Primary" and "Care", so that it becomes the National Health Service (Primary Health Care) Act.
The reason is twofold. First and most important is to emphasise that primary care is a highly appropriate place to offer preventive as well as curative health services. For many years preventive services have been provided by the best primary healthcare teams. They include, for example, ante-natal and post-natal care, immunisation and child health surveillance. More recently, health promotion and preventive care, including screening, have been made available to a wide section of the population through the best primary healthcare teams, aiming to reduce the incidence and severity of many serious disabling conditions, such as asthma, raised blood pressure and obesity, among physical conditions, as well as counselling and care for patients with drug, alcohol and some mental health problems. Including the word "Health" in the Title of the Bill will remind those who are approving pilot schemes of the wider role of primary healthcare.
In the second place, "primary health care"--often now shortened to the initials PHC--is the term by which it is known internationally, especially by the World Health Organization. It is accepted as the description for the wide range in care that is appropriate in frontline community settings. It was the term used at the pioneering international conference in 1978 at Alma-Ata, which gave such a worldwide boost to primary health care as a concept. I do not suggest that "Primary Health Care" should be substituted throughout the Bill but that we should have it in the Title to show the type of activity we hope will be covered by the many schemes the Bill will allow. I beg to move.
Baroness Cumberlege: My Lords, the objective behind the amendment is one that we can subscribe to wholeheartedly. Indeed, the recognition that healthcare provision needs the team effort of a range of health and social care professionals has been an important theme in recent years. In the family health services, the idea that everything centres around the general practitioner in his surgery has increasingly given way to a team approach.
We want the new arrangements that the Bill will allow to continue and build on that approach. One significant development is that contracts for personal medical services will not have to be held exclusively by GPs; partnerships made up of, say, nurses, GPs and perhaps other professionals will be able to put forward proposals to provide services. We will also want to continue to encourage an approach to service provision which takes proper account of social factors. The White Paper, Delivering the Future, published on 17th December explicitly encourages that.
The fact that the Short Title of the Bill refers to primary care and not primary health care will not affect that in the least. The Short Title is primarily an indexing tool. It will helpfully identify the services that the Bill deals with as those which people can access directly rather than via a
Page 29, line 40, leave out subsections (3) to (6) and insert--
("(3) Except in sections 28C and 28D of the 1977 Act and sections 17C and 17D of the 1978 Act--
(a) references in any enactment (or in any instrument made under any enactment) to arrangements made under section 28C of the 1977 Act or section 17C of the 1978 Act are to be read, except where the context otherwise requires, as including references to pilot schemes; and
(b) references in any enactment (or in any instrument made under any enactment) to services under section 28C of the 1977 Act or section 17C of the 1978 Act, or to services provided in accordance with arrangements made under either of those sections, are to be read, except where the context otherwise requires, as including references to piloted services.").
Page 30, line 11, after ("Primary") insert ("Health").
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