|Health and Social Care Bill
Mr. Hammond: I am delighted that the Government tabled the amendment, as the idea of health authorities prioritising pilot services in some unspecified way was alarming. By tabling the amendment, the Minister has saved me working out how to attack paragraph (c).
Will the Minister to acknowledge the fact that the process of designation causes concern in the same way as paragraph (c) does? Alarmingly, he proposes to interfere with commercial freedom by preventing certain businesses from setting up in an area. Although it is unnecessary to do so, it would be easy to paint a picture of circumstances in which it would be sensible to defer part II applications while the structure of a pilot was put in place. The Minister must recognise the danger of a health authority choosing as its preferred partner a large national pharmacy chain, capital-rich and perhaps proposing a complex deal involving all sorts of glamorous additional benefits to the health authority. The health authority would then be in a position effectively to trade off in a deal with the provider monopoly exclusivity in a particular area. The real concern is that if ``Shoes the Chemist'' makes a deal with the health authority, all potential entrants to an area will be blocked out.
I am sure that that is not what the Minister has in mind, but he will have to draft the regulations to ensure that health authorities do not abuse their powersalthough I am aware that he has given himself the power to deal with abuses of the system. It would be helpful if he assured the Committee that health authorities would not be allowed to designate an area. He used the term ``breathing space''. In my experience of bureaucratic organisations, their idea of breathing space is a little longer than that of commercial organisations. One can well envisage a health authority breathing a sigh of relief and saying, ``We will designate our entire area, so that we can think about it for two or three years without having to process all the tiresome part II applications, and then see if we can come up with a pilot scheme''. I am sure that the Minister does not intend that to happen, but he must make sure that the power to designate cannot be used as a blocking mechanism or to create blight. We must bear in mindand this is a familiar themethat it will have an impact on the provision of services other than pharmaceutical services within the meaning of the Bill because it could prevent retail pharmacies from opening and therefore limit access to over-the-counter products.
Mr. Denham: The hon. Gentleman makes a fair point, although I am sure that he would not suggest that health authorities should be unable to take advantage of the opportunity of significant investment in the development of pharmaceutical services in a particular area if that was to the benefit of patients. However, he is quite right to stress that the power should be used carefully. Health authorities should not prolong designations any longer than necessary nor should they designate a location in the first place unless they are actively considering an LPS scheme. If the scheme came to nothing, we would expect them to cancel the designation.
It is difficult at present to be sure what the length of designation is likely to be. It will depend to an extent on the cycle in which we invite applications for LPS schemes, so central Government will have an influence on that if we proceed as we did with PMS in inviting several waves of applications. It is unlikely that the period from applications being formally invited to schemes coming into effect will be much more than a year and could well be less. If substantial capital investment is involved, the time scale might be different, but as the hon. Gentleman recognised, we have taken extensive powers to act if there is any evidence to suggest that health authorities deliberatelyor otherwiseare misusing the power.
Mr. Hammond: I am grateful to the Minister for reassuring the Committee about the Government's intention. There is a slight contradiction between what he said about patients continuing to have the choice as to which pharmacy they take their scrip and the scenario that I outlined that implies that a health authority might effectively make a deal to give one provider predominance in an area. The Minister said that he was sure that I would not want to suggest that anything that produced beneficial investment should be blocked, but that is the argument of the budding monopolist, who would say, ``If you give me a monopoly, I can make a bigger investment.'' I ask the Minister to bear in mind when he makes the regulations that although investment is good in terms of absolute provision, choice is also a good thing.
Mr. Denham: I have said nothing to contradict what I said earlier. If there is an opportunity to get the best possible servicesubject to all that I said earlierit is reasonable that a health authority developing a LPS scheme would want to obtain the best possible service for patients rather than a second-best service.
Amendment agreed to.
Clause 31, as amended, ordered to stand part of the Bill.
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