§ Question again proposed, That the Bill be now read a Second time.
§ Mr. Whitney
I welcome the support for that and I am sure that in Committee we shall be able to make sure that all the details are well worked out.
I shall try to cover as many of the points that have been made as possible in the time available, but if I cannot do so, and if they are not likely to be covered in Committee, I shall write to the hon. Members concerned.
The hon. Member for Holborn and St. Pancras (Mr. Dobson) referred to the Health and Safety at Work etc. Act. He feels that the Crown notice arrangements are inadequate. In fact, they are working well. Although 300 notices have been issued since 1980, in no case was it found necessary to take action. We believe that that shows that, in that area, the NHS has a good record.
The problem of the 1 km or 2 km distance was of concern to several hon. Members, among them my hon.
826 Friend the Member for Northampton, South (Mr. Morris). When a decision on awarding a new contract is made, there are no distance rules at all. That decision rests entirely on the needs of the local people and what is reasonable in the circumstances. The 2 km rather than the 1 km rule is a qualifying condition only for the additional support paid to essential small pharmacies. Under the scheme, the intended effect is that small pharmacies in sparsely populated areas remain viable and continue to provide the service that we are seeking.
Hon. Members have asked whether Crown immunity should be removed from other premises. That problem was of concern to the right hon. Member for Halton (Mr. Oakes). I thank him for his generous remarks on the content of the Bill. That is a matter for other Departments than the Department of Health and Social Security, but at the moment the Government are satisfied that the arrangements for checking on food hygiene standards in their own premises are satisfactory. To check that inspection arrangements were adequate, validation exercises were carried out in 1983 and 1985, and it is intended that others will take place in future years. Therefore, that area will be monitored and considered on its merits by the Department concerned.
The right hon. Member for Stoke-on-Trent, South (Mr. Ashley) was uncharacteristically ungenerous in his comments on the removal of Crown immunity, saying that we have gone 50 yd in a one-mile walk, and that we are helping evasion. I reject that charge. I believe that our proposals will satisfy all the anxieties that we all feel about the standards in some, by no means all, Health Service hospitals. I endorse the tribute that my right hon. Friend the Minister for Health paid to the vast majority of people who work in the NHS and NHS hospitals.
My hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) raised several points about opticians. It is a cost-plus contract—plus the understanding that the costs will be repaid, whatever they are. The actual costs incurred can, by definition, be determined precisely only in retrospect. Meanwhile, the contractors are paid on the basis of a forecast. It is only fair to adjust those forecasts when the real figures are known, whichever way the error goes. In the past, we have paid back large sums of money under these arrangements, and the clause does no more than provide for the present arrangements.
I confirm what my right hon. Friend has already said, that we have undertaken not to recover the £11 million from the opticians. The £14.2 million was the sum that we believed was due. Recovering £11 million would have left the opticians with an element of profit and would have kept the repayment period to a reasonable time. However, we decided not to try to recover either the full amount or the £11 million. I hope that that satisfies my hon. Friend.
My hon. Friend the Member for Exeter (Mr. Hannam) is very experienced in health matters, and has a record of fighting for the elimination of Crown immunity. He regaled us with the horrors of bad kitchens. I endorse the point he made, that very often it is a question of management failure. I believe that the approach that we have now adopted and the institution of general management within the Health Service is contributing significantly to the improvements of those standards.
A number of hon. Members expressed concern about the appeals system in the award to pharmacists and said that there was no national appeal. This was one of the 827 details that were negotiated in the settlement reached with the pharmacists' representatives, and it was discussed very thoroughly at the time. We believe that the issue to be determined is one of local need. It seems right that it should be determined locally.
The FPCs are charged with the duty of planning local services, and this decision falls fairly and squarely within that remit. We do not think that a national appeal would bring any understanding of the local circumstances. Analogies are drawn with the Rural Dispensing Committee and appeals against its decisions, but the circumstances are not identical. The RDC is a single special health authority. There are no similar bodies with similar experience. When the RDC was set up, FPCs were not separate health authorities to which such tasks could be delegated. We believe that this is a suitable solution, but I undertake that we shall monitor it carefully.
The main burden of concern for some of my hon. Friends—particularly my hon. Friend the Member for Tatton (Mr. Hamilton) and my hon. Friend the Member for Northampton, South—related to the effects of limiting competition in the pharmaceutical services. I totally share their commitment to the free market and to the operation of market forces, but we must understand that in this area we are not talking about the pure operation of market forces. We are talking about an NHS contract and the award of a benefit. Therefore, we are not restricting the establishment of a pharmacist in a practice. The pharmacist can set up a practice without an NHS contract. He can also practise in a hospital pharmacy, in industry, in the private sector or in education. It is illogical to argue that, just because someone has an appropriate qualification, he is entitled to be supported in that 828 profession at public expense, despite the needs of patients or the taxpayer. That is a balance that we must strike in our management of NHS resources.
That brings me to the favourite hobby horse of the hon. Member for Wrexham (Dr. Marek), who now seems to have found a new ally in seeking to suggest that this Government are not devoting new and very substantial resources to the Health Service. As the hon. Gentleman well knows, the increase in Health Service resources this year will be 24 per cent. compared with 1978–79. [Interruption.] I know that this is unwelcome news for hon. Members opposite, but it is a fact. This year, an additional £650 million will be available in the Health Service and, if it is necessary, part of that money will be available to use for the upgrading of the National Health Service hospitals. Therefore, I submit that these measures are beneficial to the Health Service, and that the resources we have made available will enable that benefit to be realised.
§ Question put and agreed to.
§ Bill accordingly read a Second time, and committed to a Standing Committee pursuant to Standing Order No. 42 (Committal of Bills).