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Consideration and Third Reading


1. Proceedings on Consideration and Third Reading shall be completed at today's sitting.


2. Proceedings on Consideration shall (so far as not previously concluded) be brought to a conclusion at Nine o'clock.
3. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at Ten o'clock.
4. Sessional Order B (Programming Committees) made by the House on 7th November 2000 shall not apply to proceedings on Consideration and Third Reading.

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Consideration of Lords Amendments and further messages from the Lords


5. Paragraphs (6) and (7) of Sessional Order A (varying and supplementing programme motions) made by the House on 7th November 2000 shall not apply to proceedings on any programme motion to supplement this order or to vary it in relation to--


(a) proceedings on Consideration of Lords Amendments; or
(b) proceedings on any further messages from the Lords,
and the question on any such motion shall be put forthwith.

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Orders of the Day

Health and Social Care Bill

As amended in the Standing Committee, considered.

New Clause 11

Enhanced criminal record certificates


'.--(1) Section 115 of the Police Act 1997 (enhanced criminal record certificates) shall be amended as follows.


(2) In subsection (2)--
(a) the word "or" after paragraph (a) shall be omitted; and
(b) at the end of paragraph (b) there shall be inserted "or
(c) in relation to an individual to whom subsection (6C), (6D) or (6E) applies."
(3) After subsection (6B) there shall be inserted--
"(6C) This subsection applies to an individual included or seeking inclusion in any list prepared for the purposes of Part II of the National Health Service Act 1977 of--
(a) medical practitioners undertaking to provide general medical services,
(b) persons undertaking to provide general dental services,
(c) persons undertaking to provide general ophthalmic services, or
(d) persons undertaking to provide pharmaceutical services.
(6D) This subsection applies to an individual who is--
(a) a director of a body corporate included or seeking inclusion in a list referred to in subsection (6C)(b) or (c),
(b) a member of a limited liability partnership included or seeking inclusion in a list referred to in subsection (6C)(c),
(c) a member of the body of persons controlling a body corporate (whether or not a limited liability partnership) included or seeking inclusion in a list referred to in subsection (6C)(d).
(6E) This subsection applies to an individual included or seeking inclusion in any list prepared by a Health Authority under--
(a) section 28DA of the National Health Service Act 1977 or section 8ZA of the National Health Service (Primary Care) Act 1997 (lists of persons who may perform personal medical services or personal dental services), or
(b) section 43D of the 1977 Act (supplementary lists),
and to an individual included or seeking inclusion in any list corresponding to a list referred to in paragraph (a) prepared by a Health Authority by virtue of regulations made under section 43 of the Health and Social Care Act 2001 (which provides for the application of enactments in relation to local pharmaceutical services).".'.--[Mr. Denham.]

Brought up, and read the First time.

4.55 pm

The Minister of State, Department of Health (Mr. John Denham): I beg to move, That the clause be read a Second time.

Madam Deputy Speaker (Mrs. Sylvia Heal): With this it will be convenient to discuss the following: Government new clause 12--Conditional inclusion in medical, dental, ophthalmic and pharmaceutical lists.

Government amendments Nos. 40 to 109.

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Amendment No. 32, in clause 28, page 31, line 11, at end insert--


'(7) Before making regulations under this section the Secretary of State must consult such organisations as he thinks fit appearing to him to represent medical practitioners providing personal medical services or personal dental services as the case may be.'.

Government amendments Nos. 110 to 113.

Amendment No. 31, in clause 34, page 36, line 27, at end insert--


'(4) If the relevant authority makes a direction to a Health Authority under subsection (3) it shall make directions at the same time requiring the Health Authority to contract with each participant in a pilot scheme brought to an end as a result of a direction under subsection (3) to provide Part II services from the premises from which he was participating in the pilot scheme.'.

Government amendments Nos. 132, 137 and 139.

Mr. Denham: I should like to preface consideration of this group of amendments with some introductory remarks that will put them into context. In this group, we are proposing two new clauses and various amendments to clauses 20 to 29. Together, they will substantially update the provisions for managing primary care practitioner lists. The health authority lists of practitioners underpin health authority systems for managing primary care services and for assuring quality.

The clauses will modernise the system by giving health authorities powers to suspend or remove practitioners from their lists; by extending those arrangements into the new service delivery arrangements, such as personal medical services, under part I of the National Health Service Act 1977; by giving health authorities powers to remove practitioners from their lists on grounds of their unsuitability, as well as in the interests of the efficiency of the service or because of fraud; and by giving practitioners rights of appeal to the Family Health Services Appeal Authority against decisions by their health authority to remove them from its list.

At the same time, we are reconstituting the appeals authority, so that it will be fully independent of the Secretary of State, and including provisions to ensure that the new system operates quickly to address any risks to patients or to the service and effectively to deliver outcomes that are proportionate and fair to practitioners.

The legislation is, however, only part of the new arrangements that we are putting in place. We are developing primary care trusts and clinical governance arrangements. In the next year, beginning in April 2001, we are introducing appraisal for all general practitioners. We are also introducing the new National Clinical Assessment Authority.

We think that only a very small number of practitioners are likely to be removed or suspended under the new arrangements. Suspension or removal may not be the best response. In the first instance, support through clinical governance or reference to the NCAA may be the appropriate response. We need to know, however, that we have effective powers in place if they are necessary.

This group of amendments includes Government new clauses 11 and 12. Although I accept that there seems to be a long list of amendments in this group, they are designed to give effect to the proposals which I explained in Committee and which I have just outlined. They are

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intended to refine the provisions, to deliver a consistent approach for all the primary care practitioner professions and to achieve the best balance between safeguarding patients and the rights of the practitioner.

There are so many amendments because the legislation is complex and necessarily deals with each practitioner group separately. There are four separate groups--doctors, dentists, pharmacists and optometrists--and one hybrid group composed of dispensing doctors. Four of those groups--doctors, dentists pharmacists and dispensing doctors--may now operate under part I or part II of the 1977 Act. Consequently, it may be necessary to replicate a simple technical amendment several times. New clause 11, for example, is accompanied by 17 consequential amendments.

I propose to concentrate in my opening remarks on the more substantive amendments, beginning with new clause 11 and its consequential amendments. Current legislation does not allow a health authority to have access to the criminal record of a doctor working in general practice. In requiring a doctor to declare his criminal convictions when he applies to join a health authority list, it is our intention that the health authority should take action to verify the information that it is given. To do that, we have to rely on the Home Office's new Criminal Records Bureau, which was established in part V of the Police Act 1997, to provide criminal records checks for employers.

5 pm

Mr. Michael Fabricant (Lichfield): Will the Minister give way?

Mr. Denham: I would like to make a little progress, if I may.

Our policy, supported by those responsible for setting up the Criminal Records Bureau, has been that the health authority should have the fullest possible report from the CRB to ensure maximum protection for the public. The Bill currently provides that health authorities will be able to obtain from the planned Criminal Records Bureau certificates issued under sections 112 and 113 of the 1997 Act to confirm the completeness of any declarations made by a doctor about criminal convictions.

New clause 11 would also enable health authorities to obtain section 115 certificates. These are enhanced criminal records certificates which provide valuable additional information to health authorities, albeit in a small number of cases. They might well help to keep an unsuitable practitioner off the health authority lists and out of primary care. As such, we do not think we should lose the opportunity to improve the level of protection available to patients.


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