HC Deb 02 May 1984 vol 59 cc366-8

'(1) The following subsection shall be added after section 5(2A) of the National Health Service Act 1977—

"(2B) The Secretary of State's functions may be permitted outside England and Wales, in so far as they relate—

  1. (a) to holidays for patients;
  2. (b) to the transfer of patients to or from Scotland, Northern Ireland, the Isle of Man or the Channel Islands; or
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  3. (c) to the return of patients who have received treatment in England and Wales to countries or territories outside the British Islands.".

(2) The following section shall be added after section 99 of the National Health Service (Scotland) Act 1978—

99A. The Secretary of State's functions may be performed outside Scotland, in so far as they relate—

  1. (a) to holidays for patients;
  2. (b) to the transfer of patients to or from England, Wales, Northern Ireland, the Isle of Man or the Channel Islands; or
  3. (c) to the return of patients who have received treatment in Scotland to countries or territories outside the British Islands.".'.—[Mr. Kenneth Clarke.]

Brought up, and read the First time.

Mr. Kenneth Clarke

I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker

With this it will be convenient to discuss Government amendments Nos. 58, 59, 67 and 111.

Mr. Clarke

I do not believe that there can be any controversy about these proposals. The opportunity is being taken in the Bill to confirm and clarify the legal powers of health authorities and to do certain things that they have been doing for some time, all of which are popular and acceptable. They have not been challenged, but if anybody doubted the legal powers of health authorities to do those things there would be unnecessary controversy. Therefore, I ask the House to support a new clause that would give statutory backing to services that authorities are already providing.

The purpose of the new clause is to extend the Secretary of State's powers—the powers reside in him and are exercised by health authorities as his agents—to provide certain services outside England and Wales. I shall cite the three main examples. The first is to provide transport and other services to transfer patients for treatment within the United Kingdom. Put in straightforward language, it is not unusual for patients to be conveyed by ambulance across the Scottish border into Scotland. I need not labour the point that we need to be sure that there is a legal power to do that so that we do not have to transfer patients between vehicles, or any such nonsense.

Secondly, and more significantly, the new clause will make it clear that health authorities can legally meet some of the costs — especially the costs of escorts — of holidays abroad provided for long-stay hospital patients. In recent years, it has been the practice for mentally handicapped patients to be taken abroad by the staff of their hospitals. That is of benefit to the patients, not least because they can appreciate the improved climate, the sunshine and so on obtained on that holiday.

Most of the cost of such a holiday is usually funded by the patient from savings from social security benefits, which tend to accrue when the patient is in hospital. However, some cost may fall on the health authority, including the cost of escorts and other services. The health authority would have to pay those costs anyway if the patient remained in hospital in this country. The purpose of the new clause is to make it clear that the legal power to meet those costs exists, even when patients are taken abroad.

Thirdly, health authorities occasionally arrange the repatriation of foreign patients who want to return to their home countries. That occurs only when the patient wants to return to the home country and the doctors agree that that is wise and desirable. It means that the health authority, on behalf of the Secretary of State, can sometimes incur expenditure outside the United Kingdom, and obviously it needs the legal powers to do so.

The remaining amendments are consequential, and. I trust that they and the new clause will receive the support of the House.

Mr. Dobson

Again, the Opposition welcome the propositions in the new clause. In view of his reception at the Royal College of Nursing annual meeting recently, we understand why the Secretary of State fancies getting involved in what Henry IV described as new broils to be commenced in strands afar remote. The bulk of people in England and Wales would like the right hon. Gentleman to get on with discharging his functions in those countries.

Question put and agreed to.

Clause read a Second time, and added to the Bill.

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