§ 20 and 21. Sir Wavell Wakefieldasked the Minister of Health (1) why doctors at a disclaimed hospital who are allowed to prescribe surgical appliances for patients sent to that hospital by the regional board under contractual arrangements are not allowed to prescribe the same surgical appliances for other patients;
(2) why a patient at a disclaimed hospital who is in need of a surgical appliance immediately and is not well enough to visit a National Health Service hospital, notwithstanding that he is a 555 contributor to the National Health Service, is compelled to buy the surgical appliance at his own expense.
§ The Minister of Health (Mr. Marquand)The reason is that the Health Service must obviously concern itself only with Health Service patients and cannot undertake to provide hospital appliances to those who elect to seek their hospital treatment outside the service. I would also remind the hon. Member that the benefits of the service do not depend on contribution.
§ Sir W. WakefieldWas not it promised when the National Health Service was introduced that patients could use it either wholly or in part? Is it not most unfair that, when there are two classes of patients in a hospital, patients of one class, needing the same appliances in the same hospital for the same illness as those of the other, and attended by the same doctors, are not allowed the use of those appliances, especially if they are too ill to go to another hospital? Does not the right hon. Gentleman think that that is most unfair? Ought he not to put that right?
§ Mr. MarquandThe patient in these cases chooses to go to the disclaimed hospital, and I cannot arrange for the expenditure of money provided by the Exchequer on the prescription of a doctor who, in respect of that patient, is in no way responsible to the Minister.
§ Mr. Nigel FisherIs not this practice on the part of the right hon. Gentleman both inconsistent and unjust? Is it not a very plain submission to the dictates of administrative convenience and rule of thumb bureaucracy? What has become of the professed policy of fair shares for all?
§ Mr. MarquandIt is submission to the doctrine of the control by Parliament of expenditure.
Dr. HillWill the right hon. Gentleman take into account that in the circumstances described in the Question a disclaimed hospital is deemed to be necessary for the purpose of treating National Health Service patients because a contract has been entered into for the purpose? Does that not raise a special consideration, entitling all persons treated in that hospital to be treated alike?
§ Mr. MarquandIt entitles those persons being treated there under contractual arrangements with the regional hospital board, and not anybody else.