HC Deb 14 February 1966 vol 724 cc942-6

Question proposed, That the Clause stand part of the Bill.

Mr. Wilkins

May I put the same question to my right hon. Friend on this Clause, which does not apply to the premises as such, accepting that in the normal case an agreement might be reached for premises to be rented. In this connection, I draw attention to the wording of subsection (1,a). But, before coming to that, I must point out to my right hon. Friend that it is not paragraph little (a). It is italic (a). As a printer, I am often irritated when I hear these things incorrectly described in the House. It is either lower case (a) or italic (a). In this instance, it is italic (a).

The words of the paragraph are: for the purpose of enabling them to purchase any equipment or furniture needed by them…". Even in premises rented from a local authority, doctors might well need to put in a fair amount of equipment and furniture—equipment rather more than furniture perhaps—and I should like to know whether that would qualify for a loan from the Corporation.

Mr. K. Robinson

I stand corrected by my hon. Friend the Member for Bristol, South (Mr. Wilkins), who, I know, is an expert in all matters typographical, but I must point out that, although having rightly drawn attention to the wording of subsection (1) paragraph italic (a), he has failed to read the first two lines of the Clause: If the Minister and the Secretary of State by order made by statutory instrument provide that… These powers will not be in operation when the Bill comes into effect. They will come into operation only by Order made by Statutory Instrument, and it is not the present intention that the Corporation shall lend for equipment.

This is a reserve power. But, on the assumption that the reserve powers is exercised by regulation at some future date, I should not imagine that doctors in health centres would be precluded from borrowing money for equipment or furniture of a kind not normally provided by the local authority.

Mr. Charles Longbottom (York)

We noted what the Minister said in Clause 3 during the Second Reading, that this was a reserve power which would be exercised at some time in the future only if there was evidence that practitioners were generally failing to obtain the assistance they needed for the purchase of equipment from existing sources. The right hon. Gentleman added that he had no evidence that this was so at present. I appreciate this, but will he agree that there may come a time in the not too distant future when this power may be needed?

I am inclined to agree with what the hon. Member for Wandsworth, Central (Dr. David Kerr) said on Second Reading—it was reiterated by several of us—that, as one casts one's mind about, one has the feeling that we are not, perhaps, doing enough at present to encourage group practice. If we did more and saw to it that within group practices doctors had all the modern facilities needed to make their medical practice really effective, it might well be that there would be need for extra finance for those practices.

I am not sure, and I take it that the Minister is not sure, quite how far the present market goes in being able to provide hire-purchase facilities for pieces of equipment of this kind, but, in so far as the market does function for this purpose, the rate of interest is fairly high at present and the agreements will run for only a small number of years.

Would I not be right in assuming that if one wants to encourage group practice one wants the groups to be able to have modern X-ray equipment, perhaps the latest type of electrocardiograph equipment and facilities for performing minor surgery on the premises? If so, one is talking about very heavy items of equipment which under the present hire-purchase regulations or under banking provisions have to be bought over a short period.

I appreciate that there may not be—I accept what the Minister says—this burden at the moment, but if one is to encourage group practices to go in for these types of medical treatment as one way of easing the present burdens on hospitals and for providing as far as one can a full relationship between the doctor and his patient in the circumstances, there may in the not-too-distant future be a case where finance will become more difficult.

I hope that the Minister will not hesitate to use this power if the need is shown.

Dr. Wyndham Davies

This provision is of great interest for two reasons. First, there is no evidence at the moment—I do not think that the Minister has been able to suggest any—that the existing organisations which serve general practitioners—the Medical Sickness Finance Corporation and the Medical Insurance Agency—have declined any loans to doctors for equipment. Cannot we leave the Clause alone and not interfere with them by Government action?

Secondly, I am not aware of any other Ministry which has power to set up a hire-purchase finance company. This seems to be a most peculiar trading activity for an organisation set up by the Government. I have heard from hon. Members opposite many criticisms of hire-purchase companies, but now it looks as though we have a proposition for a hire-purchase company to be set up by a Labour Government. I consider this rather peculiar, and I hope that the Minister will give us some sensible answers to our questions.

Mr. Gower

I am surprised that the Minister has retained for himself and the Secretary of State for Scotland the decision whether the powers under the Clause should become operative. In many comparable instances Ministers have preferred—I think particularly of powers given to the Board of Trade, for example—to reserve such a decision to a committee. I should have thought that there might be a case for this power to be left to the Corporation or an advisory committee. I should be glad if the Minister would comment on that.

4.45 p.m.

Mr. K. Robinson

The power has to be reserved to Ministers because the funds of the Corporation may well be guaranteed by the Treasury. Therefore, it will be for Ministers, on behalf of the Government, to say whether the funds shall be used for an additional purpose. But there would, as in all cases, be full consultation with the profession before the powers of the Corporation were extended in this way.

The hon. Member for York (Mr. Long-bottom) asked me, in effect, to keep an open mind on this. If the situation which he envisaged were to arise at some future date, that would produce exactly the circumstance in which one would consider implementing the reserve power contained in the subsection. I would not want to commit myself to going quite so far in encouraging the range of equipment which I thought he had in mind. One would want group practices to have all reasonable diagnostic and medical treatment facilities, but I do not think one wants to find group practice centres doing a large proportion of what would normally be done in a hospital out-patient department.

The answer to the hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies) is that I am not sure whether there is any other finance corporation set up by Statute which has the powers which this Corporation—though it will not have them to start with—may conceivably have at some future date. I thought that the Agricultural Mortgage Corporation could do this. I am not sure. It can make "other loans for agricultural purposes". One might say that that could mean loans for the purchase of agricultural equipment, but I am not certain that we have a precedent there.

At any rate, I do not think that the Committee as a whole shares the hon. Member's congenital hostility to Government action of all kinds, particularly when it is action by a Socialist Government, and I am sure that the greater part of the medical profession, unlike the hon. Member, fully welcomes the provisions in the Bill and would welcome the reserve powers given under the Clause if a situation arose in which they could properly be implemented.

Question put and agreed to.

Clause ordered to stand part of the Bill.