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Lord Richard: My Lords, lest the House slips into confrontation in its last Session, I thank the noble Viscount the Leader of the House for his kind words. We have had a vigorous relationship over the past two-and-a-half years. Certainly we have not always agreed. Our disagreements have usually been civil, but not invariably. Given the nature of your Lordships' House, of course, the incivility is dressed up in the most extraordinary politeness and charm. Therefore, when the noble Viscount began by saying nice things about me my limited classical education sent me straight back to the quotation which begins "timeo Danaos". I was wrong and I am delighted.
This House cannot function unless the usual channels can function. It is right that before the House goes down I should say that, as regards the noble Viscount and his noble friend the Chief Whip, my noble friend the Opposition Chief Whip and I are grateful for the co-operation in the functioning of the usual channels
that we have received in the past two-and-a-half years. We look forward to that continuing when positions are reversed.
Lord Annan: My Lords, perhaps I may correct the noble Viscount the Leader of the House. Sir Anthony Jay was knighted, presumably for his services to Parliament.
Viscount Cranborne: My Lords, I am most grateful to the noble Lord. As always, he knows more about these matters than I do.
On Question, Motion agreed to.
Building Societies (Distributions) Bill
4.6 p.m.
Lord Hayhoe: My Lords, I beg to move that this Bill do now pass. I wish to take this opportunity to recognise the remarkable achievement of my honourable friend Douglas French, Member of Parliament for Gloucester, in steering two Ten-minute Rule Bills through another place in the lifetime of this Parliament.
Moved, That the Bill do now pass.--(Lord Hayhoe.)
Police (Health and Safety) Bill
Lord Luke: My Lords, I beg to move that the Bill do now pass. In doing so, I wish to thank my noble friend and all other noble Lords who have spoken on this matter.
Moved, That the Bill do now pass.--(Lord Luke.)
Consolidated Fund (Appropriation) Bill
Brought from the Commons, endorsed with the Certificate of the Speaker that the Bill is a Money Bill, and read a first time.
Then, Standing Order 44 having been suspended (pursuant to Resolution of 18th March), Bill read a second time; Committee negatived; Bill read a third time, and passed, and returned to the Commons.
National Health Service (Primary Care) Bill [H.L.]
The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, I beg to move that the Commons amendments be now considered.
Moved, That the Commons amendments be now considered.--(Baroness Cumberlege.)
On Question, Motion agreed to.
1
Clause 1, page 1, line 23, after ("Part I") insert ("or III").
Baroness Cumberlege: My Lords, I beg to move that the House do agree with the Commons in their Amendment No. 1. I shall speak also to Amendments Nos. 10, 11, 17, 22, 30, 31, 43, 48, 88, 91, 94, 103, 112 and 113.
These amendments tidy up the text of the Bill and bring Scottish provisions in line with those for England and Wales. For example, they detail the manner in which a direction by the Secretary of State as to payment under an NHS contract may be enforced through the courts. They insert a definition of the term "health authority" in the 1978 Act and clarify a reference in Clause 23 to make clear that the provisions relate to GPs providing GMS and not to GPs providing PMS.
I hope that your Lordships will support these technical amendments.
Moved, That the House do agree with the Commons in their Amendment No. 1.--(Baroness Cumberlege.)
On Question, Motion agreed to.
2
Clause 1, page 2, line 19, at end insert--
Baroness Cumberlege: My Lords, I beg to move that the House do agree with the Commons in their Amendment No. 2. I shall speak also to Amendments Nos. 3 to 6, 20, 23, 28, 89 and 107.
The whole question of who should be permitted to provide services under the Bill featured prominently in our earlier discussions of the Bill. We have in fact, I believe, always been entirely at one over the objective of the Bill--to enable NHS primary care to be delivered to even higher standards across the country, as part of the NHS. Nonetheless, we listened carefully to the views put to us, both in this House and by the professions, about the possible threat of commercialisation, and we took prompt action to deal comprehensively with that threat.
The amendments now before your Lordships make it explicitly clear that only those whom we have called members of the NHS family will be able to put forward proposals for pilot schemes and make contracts with health authorities for the provision of services under the Bill. The list of those who comprise the NHS family ensures that key groups who work in the NHS--doctors,
One important feature of the new provisions is that it ensures that all professional groups encompassed by the definition of the NHS family are treated equally under the Bill. We will look at all proposals which meet the new rules we have set on their merits, regardless of the professional group they come from. However, we will expect all proposals to indicate clearly how they intend to secure the medical or dental involvement that all pilots and permanent arrangements will require.
There has been a lot of concern about the danger of commercialisation resulting from this Bill. This has always been at the periphery of what the Bill is really about. The changes made to the Bill in another place deal fully with those concerns, and I am glad to say that the British Medical Association has endorsed the changes we have made. But the changes also refocus attention on the main thrust of the Bill which is and always has been about new opportunities for the existing primary care workforce. We believe strongly that it is the NHS workforce, with its range of professional skills and expertise and its commitment to NHS principles that will develop NHS primary care and take it into the next century. That is what we want, and that is what these changes help to underpin.
Moved, That the House do agree with the Commons in their Amendment No. 2.--(Baroness Cumberlege.)
Baroness Jay of Paddington: My Lords, this is the first of a substantive group of amendments which importantly affect the operation and principle of the Bill as it was first debated and considered in detail in your Lordships' House. We certainly do not intend to debate every one of the amendments and on these Benches we accept that the amended Bill as it stands, as it has come back from the other place, will be a useful tool for an incoming Labour Government.
Nevertheless, at this stage, it is appropriate to repeat the general point which has been made several times in the past 72 hours in your Lordships' House. It would have been more appropriate to the functions of this House if the 117 Commons amendments that are now before us on this important Bill could have been considered in more detail and with less haste than will be possible this afternoon.
That applies particularly to this group of amendments, which goes to the heart of the Bill, and, as the Minister has just explained, it contains the provisions which the Government are now suggesting to deal with the problem of commercialisation which was threatened by the Bill as previously drafted. That was one of the major concerns which we on these Benches have been raising ever since the Second Reading of the Bill. Had the Government been able to accept or redraft some of the amendments which we on these Benches proposed at earlier stages, which dealt precisely with that issue, we should not have needed this rather breathless consideration this afternoon.
We know--and the noble Baroness has referred to it--that one of the important matters in relation to the Bill has been the intervention of the British Medical
As the Minister knows, because she has been kind enough to discuss this with me, we still have doubts as to whether the new clause is sufficiently strong to exclude positively commercial companies. We should have preferred a new clause which made that more specific and explicit. This afternoon the noble Baroness has said that that is done in the terms of the present amendment. But she knows also that there are private companies--for example, Unichem, BUPA and PPP--all of which have been saying very recently and publicly that they regard their plans for proposed pilot schemes as being very much still alive and on the table. I hope that they have now heard the message that the Minister has given clearly.
Finally, I ask the Minister whether she is now able to underline that commitment to the exclusion of commercial companies by correcting her earlier statement when she said:
I she were able to correct that statement, that would lay our fears to rest and make the exclusion of the private companies about which we have been concerned since Second Reading much more remote.
Lord Campbell of Croy: My Lords, I should just like to remind your Lordships of the sequence of events when this Bill came to this House and during its various stages before we parted with it and it went to another place.
During the first stages of the Bill, the BMA gave its general support to what was in the Bill. It was only two days before Third Reading, just before it was leaving us, that it issued a press release--and some of us received a document from the BMA--saying that it was very worried about the possible commercialisation which might result from the Bill. On Third Reading, my noble friend Lady Cumberlege was very sensible in saying that rather than move amendments, the matter should be sorted out in the other place. Therefore, I am glad to note that it has been sorted out in the other place and with the BMA behind the scenes.
On Third Reading, I said that I thought it was wise of the Government to suspend what they were doing until they had had an opportunity to discuss the matter with the BMA and that they had time in the other place
Only today, I received a document from the BMA indicating that it now appears to be happy with the restrictions on what is called the NHS family. Bearing in mind the atmosphere when the Bill left us to go to the other place, I am glad that those matters now seem to have been sorted out and that these amendments are being put forward.
("( ) The functions of an NHS trust include power to provide piloted services, and to do so as a member of a qualifying body (within the meaning of section (Provision of personal medical services under a pilot scheme) or (Provision of personal dental services under a pilot scheme)).")
"We do not want to rule out any sensible opportunities, including a GP being employed by a commercial organisation.".--[Official Report, 17/12/96; col. 1403.]
4.15 p.m.
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