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Lord Fraser of Carmyllie: My Lords, no. Clearly, the situation is not without its complications but I would not suggest that we should be extending the range of conditions to which exemption applies. Those who have a medical condition may wish to take advantage of the prescription prepayment certificates. Those in the United Kingdom who have done so have, on average, recouped their outlay approximately three times over. I am sure that the noble Lord will recognise that, if one tried to exempt those items required only for the treatment of the qualifying condition, an extremely complicated set of arrangements would follow, with whitelists and blacklists and doctors having to make difficult decisions about whether the particular prescription was attributable to the qualifying condition.

Baroness Robson of Kiddington: My Lords, we have heard that some drugs cost less to buy over the counter than on prescription and the fact that a patient can ask for a private prescription prepayment certificate. Would it not

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be easier for the pharmacist to be given the right to dispense the prescribed item at its correct price instead of charging the prescription price?

Lord Fraser of Carmyllie: My Lords, as I have indicated, that can be achieved by using the private prescription. One must look at the matter most carefully. There is an assumption that because the drug might be acquired at a cheaper rate by the National Health Service the price would necessarily be cheaper for the private individual going into the pharmacist. The situation is not as simple as is sometimes portrayed. I believe that it is important to continue with the system that we have. There may be casual circumstances in which people need a prescription but if they need it on a repeat basis they are probably better to use the prepayment arrangement, even if the required item costs less than the NHS prescription charge.

Baroness Jay of Paddington: My Lords, does the Minister agree that most GPs, under the terms of their service agreements, feel unable to issue the so-called private prescriptions? If the Government are anxious to see the increased use of that system, will they alter GPs' service agreements in order that they can issue prescriptions that are less costly than those of the NHS?

Lord Fraser of Carmyllie: My Lords, that arrangement is already in place. I have been anxious to establish the fact that this matter should be approached with caution. If the individual has repeat prescriptions, he might be better placed to take the opportunity of using the prescription prepayment arrangement, even if the individual item costs less than the current standing charge.

Baroness Jay of Paddington: My Lords, I am sorry to come back on this matter but the Minister may have misunderstood me. I understand the professional and legal advice to GPs to be that they should not issue the so-called private prescriptions within the terms of their service agreements. I consulted the BMA on the matter this morning and I believe that the understanding of GPs is that in order to do so legitimately their service agreements would have to be changed. Will the Government do that?

Lord Fraser of Carmyllie: My Lords, I was not aware of that view of the BMA. I understand that GPs can issue such private prescriptions but it is certainly the case that they are under no obligation to do so.

The Countess of Mar: My Lords, is the Minister aware that I have had considerable correspondence with the department on that very subject and I have come to the same conclusion as he has? But there is a problem with dispensing doctors. Dispensing doctors can write a private prescription but they are not allowed to dispense that prescription to their patients. That puts the patients of such doctors on an unequal footing with other patients. Will the Minister ensure that something is done about that?

Lord Fraser of Carmyllie: My Lords, I am aware of that complication and I shall certainly look at the matter.

Baroness Gardner of Parkes: My Lords, perhaps I may—

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Lord Graham of Edmonton: Next Question!

Baroness Gardner of Parkes: My Lords, there is not a next Question—this is the last Question on the Order Paper! I agree with the Minister that the matter should be approached with caution because it is an emotive subject. Nevertheless, I wish to press the point because he said that more than 80 per cent. of prescription items are dispensed free of charge. Even if the item you require costs only £1, if you have free prescriptions you would still like it on a National Health Service prescription because it would save whatever the amount may be. Can the system be reviewed so that, in the case of an item which is worth only £1 and is available over the counter for that amount, a patient entitled to a free prescription will still cost the NHS only £1 instead of the full dispensing amount of £5? Or does the Minister believe that such a system would so endanger the pharmacy industry that that factor should perhaps be taken into consideration? That is why I suggest that the matter should be investigated.

Lord Fraser of Carmyllie: My Lords, the assumption underlying the question is that the only cost to be considered is the cost of the drug. Clearly, administering the system of prescriptions throughout the United Kingdom is expensive. The cost to be considered is not only the cost of the drug but administration and other dispensing fees.

Prisoners (Return to Custody) Bill

3.28 p.m.

The Earl of Lauderdale: My Lords, I understand that no amendments have been set down to this Bill and that no noble Lord has indicated a wish to move a manuscript amendment or to speak in Committee. Therefore, unless any noble Lord objects, I beg to move that the order of commitment be discharged.

Moved, That the order of commitment be discharged.—(The Earl of Lauderdale.)

On Question, Motion agreed to.

Carers (Recognition and Services) Bill

Read a third time, and passed.

Insurance Companies (Reserves) Bill

Read a third time, and passed, and returned to the Commons with amendments.

Disability Discrimination Bill

3.30 p.m.

The Minister of State, Department of Social Security (Lord Mackay of Ardbrecknish): My Lords, I beg to move that the House do now again resolve itself into Committee on this Bill.

Moved, That the House do now again resolve itself into Committee.—(Lord Mackay of Ardbrecknish.)

On Question, Motion agreed to.

House in Committee accordingly.

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[The PRINCIPAL DEPUTY CHAIRMAN OF COMMITTEES in the Chair.]

Clause 7 [Exemption for small businesses]:

Baroness Hollis of Heigham moved Amendment No. 52A:


Page 5, line 21, at beginning insert ("Until 1st April 1997,").

The noble Baroness said: This part of the Bill deals with employment matters and, in particular, it excludes small firms with fewer than 20 employees from the provisions of the Bill. I understand that subsequent amendments are to be moved by the noble Lord, Lord Swinfen, which propose bringing small firms within the remit of the Bill on a phased timescale. Obviously, in the absence of anything else, we support that.

However, Amendment No. 52A would not allow small firms to be exempt after 1st April 1997. In other words, after 12 months small firms, alongside large firms, would come within the framework of the Bill. They would not be allowed to discriminate against disabled employees where the disability was not relevant to the job or where accommodation for the disability could be made at reasonable expense.

Small firms represent some 35 per cent. of the labour market, or 17 per cent. if the self-employed are excluded. They represent something like 96 per cent. of all businesses. They are the fastest-growing sector of the economy. Between 1979 and 1986, 750,000 small businesses were formed in this country. In particular in the rural economy—for example, Devon, Norfolk and Wales—it is difficult to find any businesses which employ more than 20 people. Almost by definition, larger businesses tend to be in more urban areas. Therefore, to exclude small businesses with fewer than 20 employees means that for large swathes of the country, when disabled people seek work, they will be without the protection offered by this Bill. Is that reasonable? Why should they be excluded?

The figure of 20—firms employing fewer than 20 employees—was imported from the old quota system established in 1944 when the nature of the business structure in this country was very different. That was obviously because, on rounding down, firms with fewer than 20 employees would come to less than one full-time employee, and the 3 per cent. meant that 20 was a good and effective rough and ready figure.

But that has not applied in subsequent legislation. For example, in race legislation there is no minimum quota figure. Major health and safety legislation applies to all firms, irrespective of their size. The Sex Discrimination Act 1975 began by excluding firms with fewer than five employees and I understand that that exclusion has now been abolished.

Therefore, is it reasonable to exclude small firms with fewer than 20 employees? What are the arguments in favour of it? The first argument which the Government advanced in the other place is that to adapt companies for disabled people's employment is expensive and therefore that would be an unacceptable burden on small businesses; and as small businesses are the seedcorn of the future it is unreasonable to burden them with additional and bureaucratic expenses which they can ill afford and which may therefore strangle their development.

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On this side of the Committee we are as anxious as all Members of the Committee to see small businesses flourish. But the costs of adaptation to allow employment of disabled people have often been wildly exaggerated. In the United States, two-thirds of all companies made adaptations which cost less than 500 dollars. It has been estimated by employers that the average adaptation of a company to allow full physical access for disabled people is on average £200. That is the kind of burden that we are talking about. That is the average cost to make small companies physically accessible for disabled people.

What of the secondary costs which small businesses fear—not just the cost of physical adaptations but the personnel costs? I believe that the noble Baroness, Lady O'Cathain, mentioned those on an earlier debate; for example, the time off required for sickness, medical appointments or for coverage. That point was addressed by the noble Lord, Lord Carter, who said that, overall, disabled people have better and more reliable employment records than non-disabled people. A 1990 Devon careers study showed that 93 per cent. of employers found that disabled people performed as well as or better than able-bodied people. They had fought harder for the job and were determined to keep it. Moreover, 45 per cent. of employers found the attitude to work of disabled people was as good as that of able-bodied people and 55 per cent. found that it was better. Therefore, only a tiny fraction found the attitude to work of disabled people less acceptable than that of able-bodied people.

As regards attendance—the point raised by the noble Baroness, Lady O'Cathain—70 per cent. of employers found the attendance of disabled people equally good and 26 per cent. found it to be better than that of average able-bodied people. In other words, only 4 per cent. found that there was a problem in relation to personnel issues.

Therefore, the financial costs to provide access are on average about £200, which in any event is covered by "reasonable cost", and the personnel costs of disability are not shown to create the problems which it is perhaps perceived that they do. On the contrary, the attendance, regularity and reliability of disabled people on the whole is better than able-bodied people and those arguments in relation to small businesses are therefore simply not valid. Consequently, the argument to exclude small businesses because we would be imposing an unreasonable cost on them if they were to fall within the framework of the Bill is not true. It does not exist in relation to physical adaptations of premises or in relation to personnel. If we stopped thinking of disabled people as a burden but instead thought of widening the opportunities for employers to invest in human capital, it is clear that disabled people are a very sound investment indeed.

The second argument relates to the views of small businesses. The Government's Red Book, which has a summary of responses at Table 26, shows that, of 250 organisations which commented, 200 did not wish to see small firms excluded from the provisions of the Bill. Within that, six voluntary organisations would go along with excluding small firms but 59 would not. Four local authorities would go along with the exemption but 43 would not. Of course, when one talks about local

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authorities one must think of contract compliance and cost centres. There are very small subsections within local authorities in relation to which the fewer-than-20 rule would apply. Of the employers who responded, one employer would wish to see small firms excluded and 10 would not. The rest were so concerned about the issue that they did not bother to respond to the question.

Therefore, only one employer favoured the exclusion of small companies while the rest favoured their inclusion or were indifferent. Therefore, evidence from the consultation exercise does not show that small businesses need to be excluded because they are asking for that. It will not be costly and small businesses are not calling for that exemption.

The Government may say that the responses are all from larger firms like the CBI and that "they would call for it, wouldn't they?" It is worth reminding ourselves that over 50 per cent. of the companies that the CBI represents, including the trade associations of small companies, have fewer than 20 employees. Therefore, when the CBI and the Employers Forum on Disability call for small firms to come within the Act they are speaking for their constituency which includes small businesses. We believe that it is not right that a disabled person's access to employment should depend on who employs him and where he lives, as will be the case if the Bill passes unamended.

Nonetheless, we still support the fall-back amendment of the noble Lord, Lord Swinfen. However, we have been swayed on one side by a consideration which was brought to our attention by the Employers Forum on Disability and by the CBI. All organisations are protected from having to make adaptations which are unreasonably costly. If small firms were excluded altogether at this stage, then what counts as unreasonably costly would be determined by the firms to which the Act would initially apply. Those are the larger firms; that is, those with over 20 employees. When, five or 10 years on, as would be the case under the amendment of the noble Lord, Lord Swinfen, smaller firms were required to make similar adjustments, the concept of reasonableness would have been determined by the larger firms through litigation and through the courts of law and smaller companies would have lost their voice. We believe that that could be to their disadvantage.

It would be much better for smaller firms to be in with the larger firms from the beginning as regards determining what counts as reasonable cost, reasonable access to premises and reasonable personnel costs. I believe that all those factors should be considered together. Therefore, given that fact and given that, in all the circumstances, no firm is asked to do anything that is unreasonably expensive, we do not believe that small firms should be excluded from the Bill. We do not believe that they need the double protection both of reasonable cost and of size. However, we do believe that they may continue to exhibit discriminatory practices unless they are required to comply with the law. We also believe that small companies which want to employ disabled people may fear that they will be undercut competitively without such inclusion.

We believe that there is no justification, when one explores the matter in detail, for excluding small firms from the Bill. On average, the cost of physical adaptations

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is only £200. They can well afford that. The costs of personnel are not evident; on the contrary, all the evidence that we have shows that disabled people produce more effective, reliable and cost-free services. Finally, all the evidence suggests that small firms are not calling for such an exclusion. Given that fact, let us bring them into the frame from the beginning and ensure that disabled people have full access to employment irrespective of who they work for and where they live. I beg to move.

3.45 p.m.


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