Baroness Carnegy of Lour: My Lords, it is difficult to follow what has happened to the Bill as a result of these amendments. I am grateful to the noble Lord, Lord Macdonald, who wrote to me saying that he has asked the Scottish Office officials to compile an updated consolidated version of provisions in the Bill resulting from these amendments. That is a great help.
I hope the Government have taken on board the fact that things have been difficult for us and to require a consolidated version in order to understand the Bill is obviously not good enough. I hope that both the Government and the future Ministers of the Scottish Parliament will read the tea leaves here and try and prepare legislation which is easier for Members of both Houses to understand. I am grateful for this and I am sure that Members in another place will be grateful also because they will have the benefit of it before they look at the changes. They will be able to see whether the tribunals in Scotland seem to them to be adequately provided for.
The Earl of Mar and Kellie: My Lords, I suspect I should know this, but will the Minister clarify for me whether the NHS tribunal is a UK-wide body or whether there is a separate NHS tribunal in Scotland? I believe he said that there was, but that was not my understanding.
Lord Hunt of Kings Heath: My Lords, it is my understanding that they are separate tribunals but I shall be happy to send further details of the composition and make-up to the noble Earl if he wishes.
Perhaps I may say to the noble Baroness, Lady Carnegy, that I took careful note of the comments on these matters made by noble Lords during Report stage, particularly those of the noble Lord, Lord Renton. I have ensured that those comments were brought to the attention of the appropriate people.
On Question, amendment agreed to.
Lord Hunt of Kings Heath moved Amendments Nos. 24 to 34:
Remuneration for Part II services: Scotland
Page 37, line 43, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him").
Page 37, line 46, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him").
Page 38, line 12, after ("shall") insert ("make a local disqualification, that is").
Page 38, line 14, after ("may") insert ("also make a national disqualification, that is").
Page 38, line 17, leave out from ("Tribunal") to ("they") in line 18 and insert ("make a national disqualification").
25 Mar 1999 : Column 1462
Page 38, line 31, leave out ("power to disqualify") and insert ("functions of making disqualifications").
Page 38, line 32, leave out ("includes power to make") and insert ("include making").
Page 38, line 37, leave out ("under") and insert ("by virtue of").
Page 39, line 7, leave out ("under") and insert ("by virtue of").
Page 39, leave out lines 25 to 35 and insert--
("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate.").
Page 40, leave out lines 10 to 17 and insert--
("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate.
( ) If, on a review under this section of a fraud case--
(a) there is a national disqualification which the Tribunal do not remove or make conditional,
(b) there is a national disqualification which is conditional and which the Tribunal make unconditional, or
(c) the Tribunal make a national disqualification,
they may also make a declaration of unfitness.
( ) The Tribunal shall not under this section--
(a) in the case of a conditional disqualification, make it unconditional or vary the conditions,
(b) make any further disqualification or conditional disqualification, or
(c) make a declaration of unfitness,
if they are of the opinion that it would be unjust to do so.
( ) A determination of the Tribunal under this section shall have effect--
(a) if no appeal is brought against it, at the end of the period for bringing an appeal,
(b) if an appeal is brought against it, when the appeal process is exhausted.").
The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 24 to 34 en bloc. I beg to move.
On Question, amendments agreed to.
Clause 39 [Repeal of law about fund-holding practices]:
Lord Hunt of Kings Heath moved Amendment No. 35:
Page 41, line 26, leave out from ("1978") to ("sections") in line 27.
On Question, amendment agreed to.
Clause 45 [Expenditure of Health Boards and other bodies]:
Lord Hunt of Kings Heath moved Amendment No. 36:
Page 43, line 28, leave out ("(d)") and insert ("(e)").
On Question, amendment agreed to.
Lord Hunt of Kings Heath moved Amendment No. 37:
After Clause 49, insert the following new clause--
(".--(1) For sections 28A and 28B of the 1978 Act (regulations as to remuneration) there is substituted--
"Remuneration for Part II services.
28A.--(1) The remuneration to be paid to persons who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services under this Part of this Act shall be determined by determining authorities (and they may also determine the remuneration to be paid to persons providing those services in respect of the instruction of any person in matters relating to those services).
25 Mar 1999 : Column 1463
(2) For the purposes of this section and section 28B, determining authorities are--
(a) the Secretary of State; and
(b) so far as authorised by him to exercise the functions of determining authorities, any Health Board or other person appointed by him in an instrument (referred to in this section and section 28B as an instrument of appointment).
(3) An instrument of appointment--
(a) may contain requirements with which a determining authority appointed by that instrument must comply in making determinations; and
(b) may be contained in regulations.
(4) Subject to this section and section 28B, regulations may make provision about determining remuneration under subsection (1) and may in particular impose requirements with which determining authorities must comply in making, or in connection with, determinations (including requirements as to consultation and publication).
(5) Regulations may provide--
(a) that determinations may be made by reference to any of the following--
(i) rates or conditions of remuneration of any persons or any descriptions of persons which are fixed or determined, or to be fixed or determined, otherwise than by way of a determination under subsection (1);
(ii) scales, indices or other data of any description specified in the regulations;
(b) that any determination which in accordance with regulations made by virtue of paragraph (a)(ii) falls to be made by reference to a scale or an index or to any other data may be made not only by reference to that scale or index or those data in the form current at the time of the determination but also by reference to the scale, index or data in any subsequent form attributable to amendment or revision taking effect after that time or to any other cause.
(6) Regulations may--
(a) provide that determining authorities may make determinations which have effect in relation to remuneration in respect of a period beginning on or after a date specified in the determination, which may be the date of the determination or an earlier or later date, but may be an earlier date only if, taking the determination as a whole, it is not detrimental to the persons to whose remuneration it relates;
(b) provide that any such determination which does not specify such a date shall have effect in relation to remuneration in respect of a period beginning--
(i) if it is required to be published, on the date of publication;
(ii) if it is not so required, on the date on which it is made.
(7) A reference in this section or section 28B to a determination is a reference to a determination of remuneration under subsection (1) of this section.
Part II remuneration: supplementary.
28B.--(1) Before a determination is made by the Secretary of State which relates to all persons who provide services of, or of a category falling within, one of the descriptions of services mentioned in section 28A(1), he shall consult at least one of the following bodies--
(a) a body one of whose functions is to provide advice in connection with the matters to be determined; or
25 Mar 1999 : Column 1464
(b) a body appearing to him to be representative of persons to whose remuneration the determination would relate.
(2) Determinations may make different provision for different cases including different provision for any particular case, class of case or area.
(3) Determinations may--
(a) be made in more than one stage;
(b) be made by more than one determining authority;
(c) be varied or revoked by subsequent determinations.
(4) A determination may be revised--
(a) to correct an error; or
(b) where it appears to the determining authority that it was made in ignorance of or under a mistake as to a relevant fact.
(5) Determinations may, in particular, provide that the whole or any part of the remuneration--
(a) is payable only if the determining authority is satisfied as to certain conditions; or
(b) is to be applied for certain purposes or is otherwise subject to certain conditions.
(6) Subject to sections 19(3) and 25(3), remuneration under section 28A may consist of payments by way of--
(d) reimbursement (in full or in part) of expenses incurred or expected to be incurred in connection with the provision of the services or instruction,
and may be determined from time to time.
(7) At the time a determination is made or varied, certain matters which require determining may be reserved to be decided at a later date.
(8) The matters which may be reserved include in particular--
(a) the amount of remuneration to be paid in particular cases;
(b) whether any remuneration is to be paid in particular cases.
(9) Any determination shall be made after taking into account all the matters which are considered to be relevant by the determining authority and such matters may include in particular--
(a) the amount or estimated amount of expenses (taking into account any discounts) incurred in the past or likely to be incurred in the future (whether or not by persons to whose remuneration the determination will relate) in connection with the provision of services of the description in section 28A(1) to which the determination will relate or of any category falling within that description;
(b) the amount or estimated amount of any remuneration paid or likely to be paid to persons providing such services;
(c) the amount or estimated amount of any other payments or repayments or other benefits received or likely to be received by any such persons;
25 Mar 1999 : Column 1465
(d) the extent to which it is desirable to encourage the provision, either generally or in particular places, of the description or category of services to which the determination will relate;
(e) the desirability of promoting services which are--
(i) economic and efficient; and
(ii) of an appropriate standard.
(10) If the determination is of remuneration for a category of services falling within one of the descriptions of services mentioned in section 28A(1), the reference in subsection (9)(a) to a category of services is a reference to the same category of services or to any other category of services falling within the same description."
(2) Sections 28A and 28B of the 1978 Act as substituted by this section have effect in relation to--
(a) the making of determinations on or after the commencement of this section; and
(b) the variation, revocation or revision on or after the commencement of this section of determinations whenever made,
and in this subsection "determinations" means determinations under Part II of the 1978 Act of the remuneration to be paid to persons who provide services mentioned in section 28A(1).
(3) Section 7(4) of the Health and Social Security Act 1984 and section 15(3) of the Health and Medicines Act 1988 (determinations of remuneration for services under Part II of the 1978 Act deemed to be valid) have effect in relation to Scotland as if--
(a) after "inserted by this section" in section 7(4)(b) of the 1984 Act; and
(b) after "section 7 of the Health and Social Security Act 1984" in section 15(3) of the 1988 Act,
there were inserted "and before the coming into force of section (Remuneration for Part II services: Scotland) of the Health Act 1999".
(4) The reference in section 28B(6) of the 1978 Act (as substituted by this section) to section 19(3) of that Act is to be read on and after the commencement of section 10 of the National Health Service Act 1966 as a reference to that section.").
On Question, amendment agreed to.
Clause 50 [Disqualification of Part II practitioners]: