NATIONAL HEALTH SERVICE (AMENDMENT) BILL (Hansard, 9 July 1957)

§ LORD BURDEN
My Lords, I beg to move that this Bill be now read a second time. At this late hour, I hope it will not be necessary to detain your Lordships for more than a few moments in connection with the Bill. The object of the Bill is to enable local health authorities—that is, the county and county borough councils—to make their ambulances available for use, on repayment, for suitable purposes outside the scope of the National Health Service Acts. In January, 1956, the Guillebaud Committee, which inquired, as your Lordships will recollect, into the cost of the National Health Service, recommended inter alia that amending legislation should be introduced to make clear beyond any doubt that local authorities had the power to levy a charge when ambulances are provided for purposes outside the scope of the National Health Service Act.
There is power under Section 63 of the National Health Service Act, 1946, enabling local health authorities to provide their ambulances, on repayment, for any of the purposes of authorities constituted under the Act. This power is used, for example, in the occasional provision of ambulances to take mental defectives to occupation centres. Local health authorities have no power, however, to run their ambulances, on repayment, for purposes, however suitable or desirable, outside the National Health Service. The establishment of a comprehensive public ambulance service has led to the disappearance of many ambulance hire firms and to-day the only ambulances available in a district may be those provided by local health authorities.
The new power in this Bill could be used, for example, to provide ambulances to stand by at sports meetings or other large public gatherings to deal with possible casualties, and, of course, the promoters may be willing and anxious to pay for such a service. Again, most large industrial undertakings are obliged by Statute to provide ambulance facilities for their employees. It is obviously more convenient for all concerned if this obligation can be discharged by the local health authority on an agency basis. The 884 new Bill would remove any doubt as to a local health authority's power to enter into such an arrangement. Schemes in which workmen requiring out-patient treatment but able to use public transport are taken at fixed times to hospital from their work and back again in order to reduce the time away from work, could be operated on behalf of the employers and employed concerned.
I should make it clear, however, that the Bill does not enable extra vehicles to be provided for purposes of the Bill over and above what is necessary for the authorities in discharge of their duties under Section 27, and authorities would, therefore, only be able to supply ambulances for reward under the power conferred by the Bill when this could be done without impairing the standard of service to be provided under Section 27. But those of us with any knowledge of the working of the ambulance services to-day know that most authorities have spare capacity outside peak hours which could be usefully employed on such work as this Bill suggests. Authorities would be expected to ensure that a full economic charge was made whenever ambulances were used under their new power. May I make it clear that there is no question of imposing a charge on members of the public for ambulance journeys within the National Health Service.
Clause 1 (2) seeks to exempt local health authorities from the provisions of the Road Traffic Acts, 1930 to 1956, requiring motor vehicles used for carrying passengers for hire or reward to be licensed as public service vehicles. As the law stands, if payment is made for the carrying of patients in a local health authority's ambulance, the vehicle would need to be licensed as a public service vehicle. Although the number of occasions when individual patients will be carried at their own expense in a local authority's ambulance is likely to be very small, it is desirable that local authorities' ambulances should be granted general exemption from this licensing requirement.
My Lords, this Bill was introduced in another place by a Member sitting on the Government side, and was carried through all its stages without any opposition. May I suggest to your Lordships that the Bill is a common-sense and practical measure 885 which will enable local authorities to perform useful services which are at present, rather illogically, outside their scope? It is because of that that I venture to commend the Bill to your Lordships' House. I beg to move.

§ LORD AMULREE
My Lords, I should like, extremely briefly, to support what the noble Lord, Lord Burden, has said about this Bill. I am sure that the various anomalies to which he has referred are perfectly genuine. One has come across instances where the ambulance service has been rather hampered by the restrictions upon it, and I am sure that this Bill will do a great deal to remove those anomalies. I am sure that noble Lords on these Benches have great pleasure in supporting the Bill.

§ THE MINISTER OF STATE, SCOTTISH OFFICE (LORD STRATHCLYDE)
My Lords, I rise merely to say that the Government consider this a useful Bill and give it every support. Its purposes have been explained in detail by the noble Lord, but if I may put the position in my own words it is that, on the one hand, there is a demand for ambulances on hire, and on the other there is a supply available in the local authorities in England and Wales who maintain ambulances as part of the National Health Service. What the Bill does is to enable the supply to meet the demand.
As the noble Lord has said, it is obviously a sensible measure, especially now that the number of privately-owned ambulances is much smaller than it used to be. The Bill applies only to the use of ambulances for purposes outside the National Health Service, and therefore does not mean—here again the noble Lord made the point—that people will be charged for the service that they now get free. I understand that the intention is to send out ambulances on hire only when they are not in use as part of the National Health Service. My Lords, I join with noble Lords who have already spoken in commending the Bill to the House.