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Lord Triesman: My Lords, I thank noble Lords for what has been a brief but unquestionably useful debate, which gives us a real chance to clarify the issues. I particularly thank the noble Lord, Lord Hunt of Wirral, who has raised a number of points. As I was able to have a sense of what those points would be, I hope that I can respond to them fully and ensure that we are all in a position where we can share information. There is a sentiment on all sides of the House that we want this to work and to work sensibly.

Perhaps I may start with the noble Lord's kind invitation to say what is meant by the word "shortly" and to provide a firm date for implementation—preferably specifying January or February. I am afraid that I cannot make a specific commitment on the implementation date for periodical payments until the rule committee has completed its consideration of the rules and practice directions. That is the only reason that I am unable to do so today. Once they are finally agreed, the Government will be in a position to make a firm decision on implementation. I undertake that we will make that information available as rapidly as we can. Obviously, it is in everyone's interests that we do so.

The noble Lord, Lord Hunt of Wirral, also asked how widely Ministers expect periodical payments to be used. As I indicated in my opening remarks, the Government wish to promote the widespread use of periodical payments. I want to emphasis that in case there was any lack of connection between what was said by ministerial colleagues in different places. We wish to promote the widespread use of periodical payments, but not the widespread use of variations, which we expect to be rare.

We hope that the use of periodical payments will be appropriate in personal injury cases and that they will become the norm in those cases. I gave reasons why I thought that it was unlikely that there would be widespread use or, indeed, anything other than very narrow use of variable orders. We think that it will be limited.

Such evidence as there is—I do not want to overstate the quality of the evidence so far—was considered at paragraph 25 of the Regulatory Impact Assessment. That formed the basis for making at least some extrapolations which we think would be useful.

The noble Lord, Lord Hunt, also asked what the position is in relation to the repeal of Section 2(4) of the Law Reform (Personal Injuries) Act 1948. As he quite rightly indicated, the Chief Medical Officer recommended in his report entitled Making Amends that Section 2(4) of the 1948 Act should be repealed so far as clinical negligence claims are concerned. Instead, packages of care should be provided under the NHS.

As a result of the wider issues that this recommendation plainly raised, the Government indicated that they intend to consider the implications
 
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for personal injury claims generally and much more thoroughly, which is a proper response to the Chief Medical Officer's views. We are giving careful consideration to the wider picture and have been discussing some of the options with stakeholders, including insurers, with a view to further consultation if appropriate.

We of course recognise the important part that rehabilitation has to play. The noble Lord, Lord Goodhart, made that point on behalf of the noble Baroness, Lady Finlay. There is a balance here to be struck. Plainly, no one would want to do anything that would prevent someone from reaching closure on what would have been an extremely difficult and unpleasant episode in his or her life. Equally, I do not think that anyone on any side of the House would want to see a decision taken which meant that some really significant change—for the better or for the worse—was not taken into account.

The noble Lord, Lord Hunt, asked for a restatement that the overriding principle in determining whether periodical payments are appropriate should be that the needs of the claimant are paramount, not the claimant's wishes. I very strongly agree on that point. On behalf of the Government, I say that we as the Government strongly agree. As the noble Lord indicated, the draft rules that are currently being finalised by the Civil Procedure Rule Committee state that in deciding whether to make a periodical payments order, the court should have regard to all the circumstances of the case and, in particular, the form of award that best meets the claimant's needs. That is the right way to go. It is the way in which we are being urged to go. It is probably the only way in which we can offset the possible risks of a compensation culture taking over in this area.

The final major question asked by the noble Lord, Lord Hunt of Wirral—I hope that I have not missed any—was whether there would be guidance and training for the judiciary and whether that guidance would be made public. I want to confirm formally today that guidance is being developed for the judiciary on the new system for periodical payments contained in Sections 100 and 101 of the Courts Act. That sort of guidance would normally be included in the Bench Book, which is available on the Judicial Studies Board's public website. It will be publicly available; it is right that that should happen.

Some points were made about funding and the position on full recovery. I hope that I have dealt at least with the issue of closure because it came up in a more general sense in our discussion today. I am aware of the difficulties that have been expressed on funding, some being expressed in the annuities market. The range of products is perhaps not as wide as it needs to be in order to deal with all of those kinds of questions. But there are discussions, which officials are actively involved in, with the insurance industry about its concerns. Those discussions focus on the issues relating to wider questions about the funding of periodical payments in general rather than simply the provisions of this order on variation. That is really the force of the argument; it needs to do that.
 
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Discussions have also taken place with medical defence organisations, which I think are right to believe that there will be some impact on their balance sheets. There may be a small increase in administrative costs. However, insurers and medical defence organisations already reserve for further damages claims in provisional damages cases. They ought to be able to do essentially the same here without making any real change in the amounts required. Estimates that have been made in the insurance industry and medical defence organisations have in general been relatively low and do not suggest that there would be a spectacular change.

I shall deal briefly with the point about full recovery. It is right to say that the order does not appear to provide for termination, but I agree with the noble Lord that the order could be reduced to a nominal sum if that were appropriate. We must make sure that that point is understood as well.

We are concerned with the approval by affirmative resolution in the House of Lords of an order prescribing the circumstances and procedures which should govern the variation of periodical payments for future loss in personal injury cases. The issues surrounding the variation of periodical payments were extensively debated in both Houses during the passage of the Courts Act 2003. I hope that noble Lords will agree that Ministers have listened carefully to the points that have been made—which have great force, there is no question about that—and have given certain undertakings about what the order would contain which are now reflected in the draft order; indeed, noble Lords opposite have generously acknowledged that.

The order provides that a court may provide that an order for periodical payments may be varied only if it is proved or admitted that there is a chance that at some definite or indefinite time in the future the claimant will, as a result of an act or omission which gave rise to the course of action, develop a serious disease or suffer a serious deterioration, or would enjoy some significant improvement, possibly even to the extent of full improvement, in the physical or mental condition where that condition had been adversely affected as a result of the act or omission. I believe that that is the fair and balanced approach, and the House too seems to have agreed with that approach, which I greatly appreciate. I hope that noble Lords feel that we have fulfilled the commitments we made and I commend the order.

On Question, Motion agreed to.

Primary Medical Services (Northern Ireland) Order 2004 (Consequential Amendments) Order 2004

Lord Warner rose to move, That the draft order laid before the House on 14 September be approved [29th Report from the Joint Committee].

The noble Lord said: My Lords, the Primary Medical Services (Northern Ireland) Order 2004 introduced a range of measures required to implement in Northern Ireland the new GP contract that had been
 
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agreed for the whole of the United Kingdom between the General Practitioners Committee of the British Medical Association and the NHS Confederation. Similar measures have been made in England and Wales by the Health and Social Care (Community Health and Standards) Act 2003, and in Scotland by the Primary Medical Services (Scotland) Order 2004.

Following the implementation of the Primary Medical Services (Northern Ireland) Order, it has been necessary to make a number of consequential amendments to other legislation. Those amendments needed for Northern Ireland only have been made by Northern Ireland statutory rules. However, due to restrictions on the competence of the Department of Health, Social Services and Public Safety in Northern Ireland, amendments to legislation which need to extend beyond Northern Ireland must be made by Order in Council following approval of the draft order by both Houses of Parliament. That is why this short and, I hope, uncontentious order is before the House today.

The Primary Medical Services (Northern Ireland) Order 2004 (Consequential Amendments) Order 2004, which we are considering today, makes a number of necessary technical but relatively minor amendments to the Medical Act 1983 and to three statutory instruments. These are the Medicines (Pharmacy and General Sale—Exemption Order 1980, the Prescription Only Medicines (Human Use) Order 1997 and the General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003.

Most of the amendments are simply to replace references to the old, pre-April 2004 general medical services in Part VI of the Health and Personal Social Services (Northern Ireland) Order with references to the new wider term, "primary medical services".

The one exception to this is the amendments found at paragraph 4(2)(b) and (4)(b) of the Schedule to the draft order. These amendments remove two paragraphs which imposed restrictions on the right to practise of certain categories of GPs to be included in the GP register by virtue of an acquired right to practise. Those restrictions are no longer necessary in the 2003 order, as they have been replaced as appropriate by restrictions in the legislation relating to the GP contract that deals with conditions for contractors and the qualifications required by performers.

My colleague the Minister of State for Health, John Hutton, has made the following statement on the compatibility of the order with the European Convention on Human Rights:

"In my view, the provisions of the Primary Medical Services (Northern Ireland) Order 2004 (Consequential Amendments) Order 2004 are compatible with the convention rights".

I beg to move.

Moved, That the order laid before the House on 14 September be approved [29th Report from the Joint Committee].—(Lord Warner.)

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