HC Deb 12 June 1973 vol 857 cc1334-47
Mr. Alison

I beg to move Amendment No. 1, in page 2, line 7, leave out '(except in Greater London)'.

Mr. Deputy Speaker (Mr. E. L. Mallalieu)

It will be convenient to take with this amendment Government amendments Nos. 3, 4, 5, 6 and 35.

Mr. Alison

The aim of this group of amendments is to bring the London Ambulance Service within the reorganised National Health Service. That was the original intention of the Bill which was frustrated, as the House knows, in another place. The Government had a chance in Committee, as a result of the eloquence of the hon. Member for Southwark (Mr. Lamborn), to consider the argument which he advanced for leaving the London Ambulance Service with the Greater London Council. On considering the matter further, the Government have concluded that the case for the transfer of the London ambulance service to the reorganised National Health Service is overwhelming.

9.45 p.m.

The Bill is specifically designed to integrate the fragmented services—hospitals, general practitioners, local authority health services, and so on—with the purpose of establishing comprehensive health care, stemming from a single source authority and competent, through that authority, to mobilise every necessary resource for the delivery of health care. Ambulances are indisputably an integral part of the armoury of health resources necessary to look after the health and well-being of patients.

This is par excellence true in the case of the London ambulance service because, unlike other ambulance services run by local government, it has never had social services responsibility. It has been purely a health instrument. It is not only in the context of the need to mobilise health resources generally that we believe that in London the ambulance service should pass to the National Health Service. We believe that it should be done particularly in view of the intimate involvement the ambulances have with the hospital service, above all with the accident and emergency departments. This is where, above all, ambulances are crucial, and there could hardly be a dimension in which health care is more specifically and precisely featured than in the provision of emergency and accident services in hospitals, necessitating transport by ambulance to get the unfortunate patients into that environment.

All these arguments have been accepted in the case of local authorities outside London as a reasonable basis for transferring the ambulance services which for many years—much longer than in London—have been run by local government. All these factors have justified there being no question of transferring the ambulances into a reorganised NHS.

Mr. John Silkin

I have had a number of complaints—I do not know whether the hon. Gentleman has—that some staff seem totally unaware of the terms and conditions in which they will be operat- ing in the ambulance service when they are transferred. Perhaps on Third Reading the hon. Gentleman may care to make a statement on that.

Mr. Alison

I will. I take the point.

The question to consider is whether London, with one of the largest ambulance services in the country, should be the odd man out in withholding its ambulance service from the reorganised NHS, especially since the London scene features the concentration of large hospitals, many of them specialist teaching hospitals, to which a very large number of people from outside London automatically flow for a whole range of services. So, above all, if ambulances are an integral part of health care, should they not be integrated in a health service in London, where there is need to co-ordinate the movement of patients, many of them from outside London, coming into the great London hospitals?

In Committee many hon. Members spoke of the aspect of democratic control as something important in the present set-up, in which the ambulance service in London is under the direct control of the Greater London Council, an elected body. But there was never any problem in the case of the local authority health services being transferred from local government to the reorganised NHS. Both parties have supported this. The principle of the removal of local authority health services at large into the reorganised NHS has received bipartisan support. It was a major feature of the last Green Paper issued by the Labour Government on the health services, and we have simply carried it forward into this Bill.

Therefore, if it was right and caused no offence to democratic principles to transfer health services from local government, why on democratic grounds should the ambulance service in London alone be excluded? There is no rational basis for doing so. The argument of democratic control is further weakened because under the old set-up the subordinate local authorities in London have been precepted by the GLC for the funds for the ambulance service, whereas under the Bill the full financing of the London ambulance service will be placed on the Secretary of State.

It is a negation of democracy that all the financing should be in the hands of my right hon. Friend and the democratic representation, so to speak, in the hands of the GLC which has no responsibility for raising the money but responsibility only for spending it. This is a negation of the concept of representation on the basis of taxation. There is a perfectly adequate democratic basis for the running of the centralised National Health Service; that is, this House of Commons. It is looked after by the skilled debating power of the Opposition and my hon. Friends.

Some argue that the GLC has operated the ambulance service very well for a long time, but in fact the GLC has been running it only since April 1965, a very much shorter time than the great bulk of ambulance services have been operated outside London, where many authorities have had them since 1946. The GLC got the service only because it was necessary to move services from Croydon County Borough and Middlesex County Council and integrate it in the GLC. We are simply perpetuating and extending the principle of unification and centralisation, which is the way in which the GLC got its ambulance and all its health services.

Mrs. Freda Corbet (Peckham)

Has the hon. Gentleman never heard of London County Council, the predecessor of the GLC, which ran a very large ambulance service which was the core of the GLC service as it is known today?

Mr. Alison

Yes, indeed, I believe I was associated with the London County Council when the hon. Lady was a distinguished member of it and I recall with pleasure the exchanges we had. Of course I am aware of this, but I am arguing that the Greater London Council control of the ambulance service is a combination of different strands from the past—the Croydon service and the LCC and Middlesex services—and that has been a GLC service for only a short space of time. All we are doing is extending the principle into the National Health Service where, clearly, ambulance services belong.

We shall have a London ambulance committee operating in a similar way to the Greater London way of running the service. On that committee there will also be regional health authorities in the Greater London area and authorities outside which have a great interest in the transportation of patients by their ambulances into the metropolis. We think there is an overwhelming case for the integration of a fragmented service into a single service within the ambit of the reorganised service.

Mr. Geoffrey Finsberg (Hampstead)

Could my hon. Friend say whether this London ambulance committee in all its actions will be subject to review by the proposed health service commissioner in the event of alleged maladministration?

Mr. Alison

Yes, of course. As soon as the London ambulance service moves into the ambit of responsibility of the Secretary of State for the Social Services it will be susceptible not only to scrutiny by the health councils but also to the ombudsman after complaints have been considered by the authorities immediately responsible for managing the service. It is right to complete the process by bringing into a single health authority this vital component in the mobilisation of forces for health care.

Mr. Harry Lamborn (Southwark)

Having emerged from my first blooding in Committee I confess that I found it a matter for regret that, no matter how strong was the case put forward for making certain changes in the original Bill, and no matter how strong such changes might have been supported on all sides of the Committee—until the vote was taken—the Government have pressed forward with their original proposals and have not been prepared seriously to consider any amendment to the proposals first placed before the House.

It is perhaps rather ironic and certainly in keeping with the pattern that the first and only substantial amendment to be moved by the Under-Secretary should be designed not to improve on original thoughts as a result of the passage of the Bill but to correct what the hon. Gentleman described as the frustrations of the original intentions of the Bill by another place in leaving the London ambulance service under the control of the Greater London Council.

The case for the retention of the London ambulance service in its present form under the GLC is overwhelming. The hon. Gentleman said that the service as at present constituted had been in existence only since 1965. As my hon. Friend the Member for Peckham (Mrs. Corbet) pointed out, there has been a London ambulance service serving the administrative county of London for almost 40 years. As Chairman of the London County Council Health Committee for the last three years of LCC administation I took part in the negotiations which led to an even finer London ambulance service covering the enlarged area of London.

It is rather ironic that it was the proposals of the last Conservative administration which recognised that there was a special case for placing the ambulance service in London not under the control of the local health authorities, as was the position throughout the country, but under the control of the GLC. The reasons which led the Government of the day in 1963 to conclude that this was a proper course are certainly as valid today as they were then. I contend that the ambulance service in London is probably the finest of its kind in the world. Certainly that is the view of the people in London because the GLC conducted a poll asking the citizens which service within the London area they considered best served the people of London, and the London ambulance service was selected by an overwhelming majority.

It is not with the approval of the citizens of London that the ambulance service is being taken out of the control of the GLC, which was democratically elected by the people of London to run that service and to be accountable to them for it. Certainly it is not the view of the Greater London Council, neither the majority party nor the minority party, and no doubt the Under-Secretary of State has had——

It being Ten o'clock the debate stood adjourned.

Ordered, That the National Health Service Reorganisation Bill [Lords] may be proceeded with at this day's Sitting, though opposed, until any hour.—[Mr. Murton.]

Question again proposed, That the amendment be made.

Mr. Lamborn

As I was saying, the leaders of both sides of the Greater London Council are of the view that the London ambulance service should remain under the control of the Greater London Council and I have no doubt that the Under-Secretary, like myself, has had representations from both Sir Reginald Goodwin and Sir Desmond Plummer urging the Government to have second thoughts about control of the service. Speaking from experience I would say that that view is shared by all members of the Greater London Council.

The Secretary of State's case in persisting with this proposal is not that it will make the service more efficient, not that it will result in financial savings—indeed, I expect to be able to indicate clearly that additional expense will be incurred—and certainly not that the change is wanted by the people of London. His case is merely the desirability of uniformity with the rest of the country, a uniformity the Conservative Government themselves rejected in 1963 when establishing the London ambulance service on its present basis.

In Committee the Under-Secretary indicated that it is the intention of the Secretary of State to create a joint committee from four regional authorities, and, as the Under-Secretary has indicated this evening, instead of the service being controlled by the council elected by the people of London, a new control of the ambulance service covering the GLC area is to be provided. Even the Secretary of State has realised that it is essential to keep the service as a going concern because it would be most difficult to replace; it would be difficult to create anything of a similar pattern. What is going to be different is the administration. The service is to be controlled by an ad hoc body formed by representatives of four regional authorities of whom, the Secretary of State indicated in Committee, the majority would come from outside the Greater London area. Instead of the service being administered by people elected by the citizens of London it will be adminstered by persons appointed by the Secretary of State himself.

Perhaps the worst aspect of tearing the ambulance service away from the control of the GLC is the separation of that service from the other services of the council. The first and most obvious matter for concern is the separation of the service from the unified control of the London fire and rescue services. London has on many occasions been thankful for the close co-ordination of these services, which in times of major disaster has been responsible for the saving of life and limb.

The dangers which arise from the lack of co-ordination are illustrated by the delays which occurred in the recent bombing outrages in London, when precious minutes were lost because the existence of two police organisations in the London area led to a lack of co-ordination which a unified service would avoid.

The London ambulance service will also be separated from other vital services of the GLC. In addition to an ambulance fleet of 1,000 vehicles, the GLC has 2,000 other vehicles and an organisation equipped to maintain that fleet. It also has a vehicle body-building section which has given a lead in ambulance design to local authorities throughout the country. The regional

boards will have to create an organisation to maintain this vast ambulance fleet. This can be done only at considerable expense, and the whole operation will reduce efficiency.

The Under-Secretary of State referred to the need for close liaison with the hospitals. I do not think he would suggest that the present close arrangements between the London ambulance service and the hospitals falls down through lack of efficiency. There is the closest co-ordination at hospital level.

I conclude by urging the Secretary of State not to take the London ambulance service away from the elected representatives of the people of London merely for administrative tidiness and a built-in resistance to democratic control—which appears to have been the theme throughout the passage of the Bill.

Question put, That the amendment be made:—

The House divided: Ayes 268, Noes 246.

Division No. 150.] AYES [10.10 p.m.
Adley, Robert Cockeram, Eric Goodhart, Philip
Alison, Michael (Barkston Ash) Cooke, Robert Gorst, John
Allason, James (Hemel Hempstead) Coombs, Derek Gower, Raymond
Archer, Jeffrey (Louth) Cooper, A. E. Grant, Anthony (Harrow, C.)
Astor, John Cordle, John Gray, Hamish
Atkins, Humphrey Corfield, Rt. Hn. Sir Frederick Green, Alan
Awdry, Daniel Cormack, Patrick Grieve, Percy
Baker, Kenneth (St. Marylebone) Costain, A. P. Griffiths, Eldon (Bury St. Edmunds)
Baker, W. H. K. (Banff) Critchley, Julian Grylls, Michael
Balniel, Rt. Hn. Lord Crouch, David Gummer, J. Selwyn
Batsford, Brian Crowder, F. P. Gurden, Harold
Bell, Ronald Dalkeith, Earl of Hall, Miss Joan (Keighley)
Bennett, Sir Frederic (Torquay) d'Avigdor-Goldsmid, Sir Henry Hall, John (Wycombe)
Bennett, Dr. Reginald (Gosport) d'Avigdor-Goldsmid,Maj.-Gen. Jack Hall-Davis, A. G. F.
Benyon, W. Dean, Paul Hamilton, Michael (Salisbury)
Berry, Hn. Anthony Digby, Simon Wingfield Hannam, John (Exeter)
Biffen, John Dixon, Piers Harrison, Brian (Maldon)
Biggs-Davison, John Dodds-Parker, Sir Douglas
Boardman, Tom (Leicester, S.W.) Drayson, G. B. Harrison, Col. Sir Harwood (Eye)
Body, Richard du Cann, Rt. Hn. Edward Haselhurst, Alan
Boscawen, Hn. Robert Dykes, Hugh Hastings, Stephen
Bowden, Andrew Eden, Rt. Hn. Sir John Havers, Michael
Braine, Sir Bernard Edwards, Nicholas (Pembroke) Hawkins, Paul
Bray, Ronald Elliot, Capt. Walter (Carshalton) Hay, John
Brown, Sir Edward (Bath) Elliott, R. W. (N'c'tle-upon-Tyne,N.) Heseltine, Michael
Bruce-Gardyne, J. Emery, Peter Hicks, Robert
Bryan, Sir Paul Eyre, Reginald Higgins, Terence L.
Buchanan-Smith, Alick(Angus,N&M) Farr, John Hiley, Joseph
Buck, Antony Fenner, Mrs. Peggy Hill, John E. B. (Norfolk, S.)
Bullus, Sir Eric Fidler, Michael Hill, James (Southampton, Test)
Burden, F. A. Finsberg, Geoffrey (Hampstead) Holland, Philip
Butler, Adam (Bosworth) Fisher, Nigel (Surbiton) Holt, Miss Mary
Campbell, Rt.Hn.G. (Moray & Nairn) Fletcher-Cooke, Charles Hordern, Peter
Carlisle, Mark Fookes, Miss Janet Hornby, Richard
Carr, Rt. Hn. Robert Foster, Sir John Hornsby-Smith,Rt.Hn.Dame Patricia
Channon, Paul Fowler, Norman Howell, David (Guildford)
Chapman, Sydney Fox, Marcus Howell, Raiph (Norfolk, N.)
Chataway, Rt. Hn. Christopher Galbraith, Hn. T. G. D. Hunt, John
Chichester-Clark, R. Gardner, Edward Hutchison, Michael Clark
Clark, William (Surrey, E.) Gibson-Watt, David Iremonger, T. L.
Clarke, Kenneth (Rushcliffe) Gilmour, Ian (Norfolk, C.) Irvine, Bryant Godman (Rye)
Clegg, Walter Glyn, Dr. Alan James, David
Jenkin, Patrick (Woodford) Neave, Airey Stanbrook, Ivor
Jessel, Toby Nicholls, Sir Harmar Stewart-Smith, Geoffrey (Belper)
Johnson Smith, G. (E. Grinstead) Noble, Rt. Hn. Michael Stodart, Anthony (Edinburgh, W.)
Jones, Arthur (Northants, S.) Normanton, Tom Stokes, John
Jopling, Michael Onslow, Cranley Stuttaford, Dr. Tom
Joseph, Rt. Hn. Sir Keith Oppenheim, Mrs. Sally Sutcliffe, John
Kaberry, Sir Donald Orr, Capt. L. P. S. Tapsell, Peter
Kellett-Bowman, Mrs. Elaine Page, Rt. Hn. Graham (Crosby) Taylor, Sir Charles (Eastbourne)
Kimball, Marcus Page, John (Harrow, W.) Taylor,Edward M.(G'gow,Cathcart)
King, Evelyn (Dorset, S.) Parkinson, Cecil Taylor, Frank (Moss Side)
Kirk, Peter Percival, Ian Taylor, Robert (Croydon, N.W.)
Kitson, Timothy Pike, Miss Mervyn Tebbit, Norman
Knight, Mrs. Jill Pink, R. Bonner Temple, John M.
Knox, David Pounder, Rafton Thatcher, Rt. Hn. Mrs. Margaret
Lamont, Norman Powell, Rt. Hn. J. Enoch Thomas, John Stradling (Monmouth)
Lane, David Price, David (Eastleigh) Thomas, Rt. Hn. Peter (Hendon, S.)
Langford-Holt, Sir John Proudfoot, Wilfred Thompson, Sir Richard (Croydon, S.)
Le Marchant, Spencer Pym, Rt. Hn. Francis Tilney, John
Lewis, Kenneth (Rutland) Quennell, Miss J. M. Trafford, Dr. Anthony
Lloyd, Ian (P'tsm'th, Langstone) Raison, Timothy Trew, Peter
Loveridge, John Ramsden, Rt. Hn. James Tugendhat, Christopher
McAdden, Sir Stephen Rawlinson, Rt. Hn. Sir Peter Turton, Rt. Hn. Sir Robin
MacArthur, Ian Redmond, Robert Van Straubenzee, W. R.
McCrindle, R. A. Reed, Laurance (Bolton, E.) Vaughan, Dr. Gerard
Vickers, Dame Joan
McLaren, Martin Rees, Peter (Dover) Waddington, David
Maclean, Sir Fitzroy Rees-Davies, W. R. Walder, David (Clitheroe)
McMaster, Stanley Renton, Rt. Hn. Sir David Walker, Rt. Hn. Peter (Worcester)
Macmillan,Rt.Hn.Maurice(Farnham) Rhys Williams, Sir Brandon Walker-Smith, Rt. Hn. Sir Derek
McNair-Wilson, Michael Ridley, Hn. Nicholas Wall, Patrick
McNair-Wilson, Patrick (New Forest) Rippon, Rt. Hn. Geoffrey Walters, Dennis
Maddan, Martin Roberts, Wyn (Conway) Ward, Dame Irene
Madel, David Rodgers, Sir John (Sevenoaks) Warren, Kenneth
Marten, Neil Rossi, Hugh (Hornsey) Weatherill, Bernard
Mather, Carol Rost, Peter Wells, John (Maidstone)
Maude, Angus Royle, Anthony Wiggin, Jerry
Maudling, Rt. Hn. Reginald Russell, Sir Ronald Wilkinson, John
Mawby, Ray Scott-Hopkins, James Winterton, Nicholas
Maxwell-Hyslop, R. J. Shaw, Michael (Sc'b'gh & Whitby) Wolrige-Gordon, Patrick
Meyer, Sir Anthony Shelton, William (Clapham) Wood, Rt. Hn. Richard
Mills, Peter (Torrington) Shersby, Michael Woodhouse, Hn. Christopher
Miscampbell, Norman Simeons, Charles Woodnutt, Mark
Mitchell, David (Basingstoke) Sinclair, Sir George Worsley, Marcus
Moate, Roger Skeet, T. H. H. Wylie, Rt. Hn. N. R.
Money, Ernie Smith, Dudley (W'wick & L'mington) Younger, Hn. George
Monks, Mrs. Connie Soref, Harold
Monro, Hector Speed, Keith TELLERS FOR THE AYES:
Morgan-Giles, Rear-Adm. Spence, John
Mudd, David Sproat, Iain Mr. Tim Fortescue and Mr. Oscar Murton.
Nabarro, Sir Gerald Stainton, Keith
Abse, Leo Clark, David (Colne Valley) Edwards, Robert (Bilston)
Allaun, Frank (Salford, E.) Cocks, Michael (Bristol, S.) Edwards, William (Merioneth)
Archer, Peter (Rowley Regis) Cohen, Stanley Ellis, Tom
Armstrong, Ernest Concannon, J. D. English, Michael
Ashley, Jack Corbet, Mrs. Freda Evans, Fred
Ashton, Joe Cox, Thomas (Wandsworth, C.) Ewing, Harry
Atkinson, Norman Crawshaw, Richard Fernyhough, Rt. Hn. E.
Bagier, Gordon A. T. Cronin, John Fisher, Mrs. Doris(B'ham,Ladywood)
Barnes, Michael Crosland, Rt. Hn. Anthony Fletcher, Raymond (Ilkeston)
Barnett, Joel (Heywood and Royton) Crossman, Rt. Hon. Richard Fletcher, Ted (Darlington)
Baxter, William Cunningham, Dr. J. A. (Whitehaven) Foot, Michael
Beaney, Alan Dalyell, Tam Ford, Ben
Bennett, James(Glasgow, Bridgeton) Davidson, Arthur Forrester, John
Bidwell, Sydney Davies, Denzil (Lianelly) Fraser, John (Norwood)
Bishop, E. S. Davies, G. Elfed (Rhondda, E.) Freeson, Reginald
Blenkinsop, Arthur Davies, Ifor (Gower) Galpern, Sir Myer
Boardman, H. (Leigh) Davis, Clinton (Hackney, C.) Garrett, W. E.
Booth, Albert Davis, Terry (Bromsgrove) Gilbert, Dr. John
Boothroyd, Miss B. (West Brom.) Deakins, Eric Ginsburg, David (Dewsbury)
Bottomley, Rt. Hn. Arthur de Freitas, Rt. Hn. Sir Geoffrey Golding, John
Boyden, James(Bishop Auckland) Delargy, Hugh Gordon Walker, Rt. Hn. P. C.
Broughton, Sir Alfred Dell, Rt. Hn. Edmund Gourlay, Harry
Brown, Hugh D. (G'gow, Provan) Dempsey, James Grant, George (Morpeth)
Buchan, Norman Doig, Peter Grant, John D. (Islington, E.)
Buchanan, Richard (G'gow, Sp'burn) Dormand, J. D. Griffiths, Eddie (Brightside)
Butler, Mrs. Joyce (Wood Green) Douglas, Dick (Stirlingshire, E.) Grimond, Rt. Hn. J.
Campbell, I. (Dunbartonshire, W.) Douglas-Mann, Bruce Hamilton, James (Bothwell)
Cant, R. B. Driberg, Tom Hamilton, William (Fife, W.)
Carmichael, Neil Duffy, A. E. P. Hamling, William
Carter, Ray (Birming'm, Northfield) Dunn, James A. Hannan, William (G'gow, Maryhill)
Carter-Jones, Lewis (Eccles) Dunnett, Jack Hardy, Peter
Castle, Rt. Hn. Barbara Edelman, Maurice Harper, Joseph
Harrison, Walter (Wakefield) McNamara, J. Kevin Rowlands, Ted
Hart, Rt. Hn. Judith Mahon, Simon (Bootle) Sandelson, Neville
Healey, Rt. Hn. Denis Mallalieu, J. P. W. (Huddersfield, E.) Sheldon, Robert (Ashton-under-Lyne)
Heffer, Eric S. Marquand, David Shore, Rt. Hn. Peter (Stepney)
Horam, John Marsden, F. Short, Mrs. Renée (W'hampton, N.E.)
Houghton, Rt. Hn. Douglas Mason, Rt. Hn. Roy Silkin, Rt. Hn. John (Deptford)
Howell, Denis (Small Heath) Mayhew, Christopher Silkin, Hn. S. C. (Dulwich)
Huckfield, Leslie Meacher, Michael Sillars, James
Hughes, Rt. Hn. Cledwyn (Anglesey) Mellish, Rt. Hn. Robert Silverman, Julius
Hughes, Mark (Durham) Mendelson, John Skinner, Dennis
Hughes, Robert (Aberdeen, N.) Mikardo, Ian Small, William
Hughes, Roy (Newport) Millan, Bruce Smith, Cyril (Rochdale)
Irvine, Rt. Hn. Sir Arthur (Edge Hill) Miller, Dr. M. S. Smith, John (Lanarkshire, N.)
Janner, Greville Milne, Edward Spearing, Nigel
Jay, Rt. Hn. Douglas Mitchell, R. C. (S'hampton, Itchen) Spriggs, Leslie
Jeger, Mrs. Lena Molloy, William Stallard, A. W.
Jenkins, Hugh (Putney) Morgan, Elystan (Cardiganshire) Steel, David
John Brynmor Morris, Alfred (Wythenshawe) Stoddart, David (Swindon)
Johnson, Carol (Lewisham, S.) Morris, Charies R. (Openshaw) Strauss, Rt. Hn. G. R.
Johnson, James (K'ston-on-Hull, W.) Morris, Rt. Hn. John (Aberavon) Summerskill, Hn. Dr. Shirley
Johnson, Walter (Derby, S.) Murray, Ronald King Swain, Thomas
Jones, Barry (Flint, E.) Oakes, Gordon Thomas,Rt.Hn.George (Cardiff,W.)
Jones, Dan (Burnley) Ogden, Eric Thomas, Jeffrey (Abertillery)
O'Halloran, Michael
Jones, Gwynoro (Carmarthen) O'Malley, Brian Tinn, James
Jones, T. Alec (Rhondda, W.) Oram, Bert Tomney, Frank
Kaufman, Gerald Orbach, Maurice Tope, Graham
Kelley, Richard Orme, Stanley Torney, Tom
Kinnock, Neil Oswald, Thomas Tuck, Raphael
Urwin, T. W.
Lambie, David Paget, R. T. Varley, Eric G.
Lamborn, Harry Palmer, Arthur Wainwright, Edwin
Lomond, James Pannell, Rt. Hn. Charles Walden, Brian (B'm'ham, All Saints)
Latham, Arthur Parker, John (Dagenham)
Lawson, George Parry, Robert (Liverpool, Exchange) Walker, Harold (Doncaster)
Leonard, Dick Pavitt, Laurie Wallace, George
Lewis, Arthur (W. Ham, N.) Peart, Rt. Hn. Fred Watkins, David
Lewis, Ron (Carlisle) Prentice, Rt. Hn. Reg. Weitzman, David
Lipton, Marcus Prescott, John Wellbeloved, James
Lomas, Kenneth Price, William (Rugby) Wells, William (Walsall, N.)
Loughlin, Charles Probert, Arthur White, James (Glasgow, Pollok)
Lyon, Alexander W. (York) Radice, Giles Whitehead, Phillip
Lyons, Edward (Bradford, E.) Reed, D. (Sedgefield) Whitlock, William
McBride, Neil Rees, Merlyn (Leeds, S.) Willey, Rt. Hn. Frederick
McCartney, Hugh Rhodes, Geoffrey Williams Alan (Swansea, W.)
McElhone, Frank Roberts, Albert (Normanton) Williams, Mr. Shirley (Hitchin)
McGuire, Michael Roberts,Rt.Hn.Goronwy (Caernarvon) Williams, W.T. (Warrington)
Machin, George Robertson, John (Paisley) Woof, Robert
Mackenzie, Gregor Roderick, Caerwyn E.(Brc'n&R'dnor) TELLERS FOR THE NOES:
Mackie, John Rodgers, William (Stockton-on-Tees)
Mackintosh, John P. Roper, John Mr. Donald Coleman and Mr. Ernest G. Perry
Maclennan, Robert Rose, Paul B.
McMillan, Tom (Glasgow, C.) Ross, Rt. Hn. William (Kilmarnock)
Question accordingly agreed to.
Mr. Alison

I beg to move Amendment No. 2, in page 2, line 19, at end insert: '(f) such other services as are required for the diagnosis and treatment of illness;'. This amendment is the result of the further consideration which my right hon. Friend undertook to give to the wording of Clause 2(2) in the light of the discussion in Committee, and particularly the remarks by the right hon. Member for Deptford (Mr. John Silkin). It gives effect to the undertaking that my right hon. Friend gave by adding to the services that he has a duty to provide to such extent as he considers necessary to meet all reasonable requirements, such other services as are required for the diagnosis and treatment of illness". It avoids any impression that there may have been that the health care team is a matter of the services specifically referred to in Clause 2(2). I hope that meets the Opposition's point.

Mr. John Silkin

We are obliged to the Under-Secretary and glad that the undertaking could be resolved in this way.

Amendment agreed to.

Further amendments made: No. 3, in page 2, line 24, leave out subsections (3) and (4).

No. 4, in page 2, line 37, leave out 26' and insert '27'.

No. 5, in page 2, line 38, leave out from '1968' to 'relate' in line 39 and insert '(which'.

No. 6, in page 3, line 1, leave out subsection (6).—[Mr. Alison.]

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