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Mr. Hammond: I do not wish to get in front of my hon. Friend in the queue. By what process did the Government originally conclude that the standard certificates were adequate and subsequently conclude that
Mr. Denham: That is a somewhat metaphysical question. The consultation document issued last summer indicated the need for the broader range of scrutiny through the Criminal Records Bureau. We are ensuring that legislation reflects that policy intent.
Mr. Fabricant: I am grateful to the Minister for giving way to me, finally. Is he aware that the Criminal Records Bureau will be using the police national computer to access the information as to whether someone working in the health service has a criminal record? Is he aware that the Home Office admits that up to 65 per cent. of the records of the Phoenix database--the system used on the police national computer--are either out of date or wholly inaccurate? How will the Minister ensure that a doctor, nurse or someone else in a position of responsibility will not be accused of having a criminal record when they do not have one? More worryingly, what provision has he made for those who do have a criminal record that does not show up in the CRB investigation? Also, what fee will be charged for the CRB inquiry? Will it be at enhanced or standard level?
Mr. Denham: Issues of accuracy are important, but they are for Home Office Ministers. We will work closely with the Home Office and we will need to follow Home Office guidance on the use of the Criminal Records Bureau. A code of practice has been set out by the CRB on the handling of data and information. I assure the House that we will work closely with the Home Office on the issue. Clearly, we wish to avoid circumstances where people are unfairly accused of crimes or are reported for complaints in relation to which they are not guilty.
I understand that a Home Office decision on the fee is imminent, but there has been no announcement as such. I do not know what the fee will be. Clearly, we will need to discuss this with the professions. The system of remunerating professions varies; there are variations in the systems for paying expenses and so on. The liability for various expenses varies from profession to profession; that is something we will need to discuss with them.
Mr. Fabricant: The Minister will be aware that there are provisions for the transmission of what the Home Office calls soft data. That is not covered in new clauses 11 or 12. What is the reason for that omission?
Mr. Denham: I should have to refer back to the drafting to clarify that point, but I can tell the hon. Gentleman that the new clauses do include what is called section 115 data--the soft intelligence to which he referred. I do not have the text of the new clauses to hand and so cannot point to the exact line as the hon. Gentleman might wish me to, but I assure him that the point is covered by the proposed amendments. Perhaps he was trying that question on, but I assure him that I understand what the new clauses are intended to achieve.
I shall deal now with new clause 12 and amendments Nos. 69, 70, 108, 109, 112 and 113. Clause 27 already introduces proposed new section 49G to the 1977 Act to allow a health authority in fraud and efficiency cases contingently to remove a person from its lists. The effect
That provides a half-way house: a person is given the opportunity to provide family health services but under sensible conditions imposed by the health authority to protect the interests of patients and the NHS. Clearly, if it is possible for there to be contingent removal from a list, it is reasonable to be able to impose conditions when a person applies to join one of the lists. New clause 12 therefore provides for a health authority to have conditional inclusion in a list to match the possibility of conditional removal.
Dr. Peter Brand (Isle of Wight): It is clearly important to have the maximum patient protection regulations, but I am worried by what the Minister said about such regulations being in the interests of the NHS. I am also concerned that new clause 12 uses the word "efficiency" but does not define it. If the word "efficiency" is not used to mean the interests of patient care, will the Minister help the House by defining it?
Mr. Denham: The term "efficiency" is not defined in primary legislation, to the best of my knowledge, but it has been used in such legislation for a very long time. It is one of the grounds on which the NHS tribunal is able to remove a practitioner from the NHS. We have sought to include the test of suitability in the new clause, but the amendments as a whole provide a consistent set of criteria needed to meet the tests set by the Bill. The use of the word "efficiency" in new clause 12 merely mirrors a usage that has appeared in legislation since the establishment of the NHS tribunal.
Amendments Nos. 69, 70, 108, 109, 112 and 113 make similar changes to those outlined in respect of the services lists. The remaining amendments in the group cover technical matters. If hon. Members want to go through them in more detail, I should be happy to do so.
Mr. John Bercow (Buckingham): The Minister will not be surprised if I return to my normal, and I think justifiable, hobby horse--the means by which regulations will be approved. Will the Minister confirm that, as usual, the Government intend that the regulations will be subject to the negative resolution procedure--that is, that no debate on the regulations and their detail will be permitted?
Mr. Denham: Normally, instruments subject to the negative resolution procedure may be prayed against, in which case there will be debate in Committee. Some of the most important and sensitive regulations in what used to be clause 59 and is now clause 62, which deals with patient information, will be subject to the affirmative resolution procedure. That has been the case since the Bill was first drafted, and it is a mark of the importance that the House and people outside it attach to those provisions.
Mr. Hammond: Before I start my speech, I draw the House's attention to my registered interests. They are not directly relevant to the subjects under discussion, but I have declared them at every stage of the proceedings on the Bill.
To take part in the schemes, new entrants will have to expend capital, principally in establishing a place of business. In Committee and, indeed, before that, Ministers told us that there will effectively be a two-way ticket for pilot schemes in personal medical services and personal dental services. If a scheme ends, the practitioner will be able to return to providing general medical services or general dental services under the former arrangements. Ministers also indicated in Committee that when LPS pilot schemes end, they intend that those involved in providing services through those schemes should have the opportunity to continue to provide pharmaceutical services under part II of the 1977 Act. The amendment would insert into the Bill the assurance that Ministers have given.
That assurance is important because if the pilots are essentially to be terminable at the whim of a politician, it is difficult to see how private sector businesses will be encouraged to invest their capital in setting up premises and delivering the services that Ministers want to be provided under those pilots. It is important that people who are contemplating investing in projects to make the pilots work know that if the scheme is terminated at the Secretary of State's whim, they will still be able to continue to provide pharmaceutical services from those premises and that their investment will be protected. That guarantee is essential to ensure full uptake of opportunities under the pilot schemes, which we support. I urge the Minister to consider including that in the Bill to send a reassuring signal, as I am sure he wants to do, to private businesses whose investment he will be seeking to encourage.
Amendment No. 32 deals with clause 28, which concerns arrangements for personal medical services and personal dental services lists. It is right and proper to include in lists those who are providing those services, which are in addition to the range of primary care services provided. There are indications that the Government are pressuring practitioners to move to PMS and PDS as the preferred modes of delivery. It would be strange if it appeared that providers of those services were being penalised in comparison with providers of general medical, dental, ophthalmic and pharmaceutical services.
Clause 27, which deals with general services, contains a specific requirement for the Secretary of State to consult with organisations that represent people providing those services. There is no similar provision requiring the Secretary of State to consult with people representing providers of personal medical services and personal dental services.
In Committee, the Government sought to justify the exclusion of any consultation with the representatives of PMS and PDS on the ground that such services were governed by a different, locally negotiated contract. However, the representative bodies concerned--largely the same as those representing providers of general medical services and general dental services--do not entirely agree with the Minister. The introduction of the national core contract in PMS somewhat undermines the Minister's argument that these contracts are wholly different, locally negotiated and not amenable to national level discussions with representative bodies.
Under clause 27, the Government are proposing to consult with the representative bodies. We think that it is proper and appropriate to include in the Bill a requirement to consult with bodies representing PMS and PDS providers before making any regulations under clause 28. It is not obvious from any debate that has been held so far what objection the Government have to such a provision, especially since, in practical terms, the Government would almost certainly discuss any such regulations with the very same body with which they were discussing clause 27 regulations.
There are 74 Government amendments and two Government new clauses in this group. I am tempted to say that that must be a record, but my time in the House has taught me that that is a dangerous statement to make--and there are Finance Bills to be taken into account. It is none the less a very large group of amendments.
The Minister has told us that these are technical amendments. I have been through them in some detail and I concede that that is right. For the most part, they are technical and, to some extent, repetitious. It is not the substance of the amendments that concerns me but the Government's need to table this vast number of amendments very late on Monday night. I thought that I was cutting it fine tabling the Opposition amendments at 10.5 pm, during the Division. However, I have since discovered that all the Government amendments were tabled after mine, cutting it very fine indeed.
What that tells us is that when we have rushed legislation, a very short gap between Second Reading and Committee and another very short gap--two or three sitting days--between Committee and Report, there is a danger that the drafting of the legislation will be found wanting. Clearly, the Government have found the drafting of the legislation wanting, and so have tabled a vast raft of amendments and new clauses in an attempt to address some of those defects. It would be stretching credulity to imagine that in the frenetic rush between Thursday, when the Committee concluded its proceedings, and 10.15 pm on Monday, when the Government finally tabled their amendments, they had exhaustively examined every aspect of the Bill and discovered every defect, given that the 100-odd defects were not discovered prior to the Bill's consideration in Committee. It is reasonable to assume that more defects will emerge in due course.
It would be useful to reflect on one of the reasons why we traditionally leave gaps between the different stages of our proceedings in legislation. It is not so that we can diligently spend our evenings reading the small print of Bills, but so that bodies outside may have an opportunity