HC Deb 02 May 1984 vol 59 cc503-5
Mr. Deputy Speaker

We now come to amendment No. 72. Mrs. Jill Knight.

Mrs. Jill Knight

I beg to move—[HON. MEMBERS: "Formally."] I am very sorry, but it is impossible to move this amendment formally. However, I shall move it with as much brevity as I can manage, hoping that the Hansard reporters can cope with the speed at which I speak.

I beg to move amendment No. 72, in page 24, leave out lines 19 to 30.

I am not sure that the Government know what they are doing in lines 19 to 30 of clause 23, and I advise them strongly to consider deleting them, as the amendment suggests. It is wrong to allow non-opticians to do general ophthalmic services dispensing because it is likely to prove contrary to public interests. However, the Government have decided to permit this and have been deaf to warnings.

That being so, do the Government intend that these unqualified dispensers will be placed in the same contractual position with the FPCs as the registered opticians? That is what the words would seem to mean.

How will the public be given access to the NHS complaints procedure against unqualified dispensers? Do the Government intend that only qualified dispensers will continue to be subject to the NHS complaints procedures while the unregistered ones, operating under the new arrangements, will have no sanctions? The provision in clause 23 deals with transitional arrangements made under the Bill. It is wrong to introduce this unnecessary complication into the FPC and NHS procedures. It will be expensive and we are always conscious of how necessary it is not to waste money. It will probably be overtaken by events because NHS dispensing, as we know it, will continue for a short time only.

NHS dispensing by qualified people subject to regulations provides an adequate service for the public. This issue is not related to price competition. While NHS dispensing remains, price control will remain whoever does the dispensing. The rationale that the Government are applying to allow non-NHS dispensing to be attempted by the unqualified to increase price competition and freedom of choice cannot and does not apply to the NHS while it exists in its present form.

The FPCs are extremely worried about this proposal. I hope that my right hon. and learned Friend will listen to them. They feel that it is wrong to include lay people in a register of professional people. The FPCs will have to deal with lay people under what is a professional service commitment arrangement. This proposal may not be as important as most of the matters in the Bill, but it worries the FPCs. Will my right hon. and learned Friend please consider it?

Mr. Kenneth Clarke

I am sorry to disagree with my hon. Friend the Member for Birmingham, Egbaston (Mrs. Knight) yet again. It is only on this issue that we disagree so persistently. The Government have taken the view, for all the reasons I gave before without satisfying my hon. Friend, that it is in the public interest to open the provision of spectacles for dispensing, after a recent prescription, to unregistered people.

It would not be illogical for the Government to allow non-registered opticians to dispense private spectacles but reserve the dispensing of general optical service spectacles to those who are registered and qualified.

It may well be, as my hon. Friend says, that this will only be a transitional change, because the Bill is drafted on the basis that as soon as the market has stabilised we will go over to some kind of grant to people on low incomes who, at the moment, qualify for free spectacles or reduction of charges, and to children, to enable them to buy reasonably priced spectacles but to retain the choice of frames and lenses that I was describing earlier.

At this stage we have no idea how short that transitional period will be. We are therefore taking the power to ensure that if it turns out to be anything other than short, as my hon. Friend says, we will enable the non-registered to provide GOS spectacles to those patients and consumers who want to obtain their spectacles from those suppliers in the same way as they obtain them at the moment from those who are already under contract.

It is our intention that if non-registered people are admitted to the GOS, the contractual arrangements between them and the FPCs will be the same as for the present contractors. In so far as there are complaints to the FPCs and discipline procedures, they tend to revolve around the terms of the contract between the contractor and the FPC.

2.30 am

If the terms are identical for the non-registered people, they will be subject to the same complaints procedure and the same liability to penalties to which we are accustomed at the moment. Perhaps there is a difficulty that so far has escaped the Government in putting the Bill in its present form, but it is reasonable to anticipate that non-registered opticians will enter into contract with the FPCs in the same way in which we contract at the moment with other dispensing opticians.

I shall consider what my hon. Friend said, but at this stage I do not feel that anyone can demonstrate the difficulties. The logic of the Government's position drives us to defend the Bill as it stands. The difficulty is that my hon. Friend and I are both being consistent. With her view, she is bound to press the amendment. With the Government's policy, we are bound to resist it. That all goes back to our earlier differences of principle. I hope that she will accept that, although no doubt this part of the Bill does not please her any more than the rest of it, at least we are maintaining the same line of argument, and I hope that she understands why we are resisting amendment No. 72.

Mrs. Jill Knight

The Minister slightly misunderstands what I am trying to suggest. I completely accept that the House has given its blessing to his intention in relation to dispensing, but I am saying that one cannot put non-registered people on all fours with the fully professional personnel because one will not even know where they are. There is no register or licensing of them. They might be here, there or everywhere. That is the matter that concerns the FPCs. I do not intend to press the amendment to a Division because it is obvious that I could not win, but I beg my right hon. and learned Friend to appreciate that the FPCs' views on those matters are worthy of consideration.

Mr. Kenneth Clarke

I shall consider carefully the views of the FPCs. One would know where those people were if they entered into a contract with an FPC. I accept that no FPC will be obliged to enter into a contract with a chap working from a barrow, but if someone develops a practice of the sort described by my hon. Friend the Member for Gillingham (Mr. Couchman), which includes some non-registered opticians working in the practice, I do not see why it should not be open for them to enter into a contract with an FPC in the same way as dispensing opticians do now. However, I shall reflect on what my hon. Friend has said, and will continue to consider what she and some FPCs say.

Mrs. Jill Knight

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

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