HL Deb 16 December 1982 vol 437 cc736-8

4.31 p.m.

House again in Committee.

Lord Trefgarne moved Amendment No. 149A:

Before Clause 20, insert the following new clause:

("Fees for certificates relating to notifiable diseases and food poisoning.

.The following section shall be substituted for section 50 of the Health Services and Public Health Act 1968

"Fees for certificates under section 48. 50.—(1) Subject to any exceptions which he may specify, the Secretary of State may direct that a District Health Authority shall pay to a medical practitioner for each certificate duly sent by him under section 48 of this Act a fee of such amount as the direction may specify.

(2) The Secretary of State may direct that different fees shall be paid under this section in relation to different circumstances.

(3) A direction under this section may make provision in relation to fees payable after a date specified in the direction.

(4) The date may be before or after the date of the direction but may not be before if it would be to the detriment of medical practitioners.

(5) Before giving a direction as to a fee under this section the Secretary of State shall consult any body accepted by him as a proper body for negotiating fees for medical practitioners.

(6) For the avoidance of doubt it is hereby declared that the fact that a medical practitioner who gives a certificate under section 48 of this Act holds the office to whose holder the certificate is required to be sent does not disentitle him to payment of the fee (if any) payable for the certificate.".'").

The noble Lord said: In speaking to this amendment I should like to speak also to Amendments Nos. 150A and 154. This clause seeks to substitute a new section for the existing Section 50 of the Health Services and Public Health Act 1968, which covers the fees paid to medical practitioners for notification of infectious diseases and food poisoning. The new section directs district health authorities to pay a fee to medical practitioners and sets out the basis for determining the fee in future. On the reorganisation of the National Health Service and local government it was the intention that health authorities should meet the cost of medical services provided to enable local authorities to fulfil their statutory functions, including those relating to public health.

Statutory cover for certain other fees under the collaborative arrangements is provided by Section 3 of the Health Services and Public Health Act 1980, but the fee for notification is outwith that statute because, in law, the obligation to provide the notice rests on the medical practitioner and not on the local authority. Health authorities have been required to reimburse local authority expenditure on notification fees since 1975 on the basis of extra statutory authority given by the Treasury. Subsection (1) of the new clause seeks to legitimise this financial liability upon health authorities and to ease administration by introducing payment directly to the notifying practitioners.

The majority of the section is concerned with future arrangements for setting the fee. The existing arrangements date from as far back as the last century. I hope your Lordships will not wish me to give further detail, although naturally I shall be happy to do so if asked. I beg to move.

Baroness Jeger

We do not quarrel with this new clause, but can the noble Lord the Minister help in connection with subsection (2), where there is reference to the fact that the Secretary of State may pay different fees, in relation to different circumstances"? I am not quite clear what kind of circumstances would warrant differential fees.

Then, in subsection (5) there is a reference to the fact that, the Secretary of State shall consult any body accepted by him as a proper body…". I wonder whether the noble Lord can give the Committee some indication of who are those "proper bodies".


This new clause reproduces what I understand is already available in current provisions elsewhere in statutes. I will take up the point which the noble Baroness has raised and will let her know if there is anything I can add. That, broadly, is also my answer in respect of subsection (5). This brings the arrangements for settling the fee into line with those for many other fees which are paid.

Baroness Mashamof Ilton

On the first day of the Committee stage I moved an amendment to give the Secretary of State the power to fund special hospital units if the need arose. Then, the noble Lord the Minister said that such an amendment was unnecessary. Why, therefore, is subsection (2) necessary? If it is necessary to deal with general practitioners, as the noble Lord is now suggesting, it makes me believe that I should move my hospital amendment again at Report stage.

Lord Trefgarne

If the noble Baroness wishes to do that, it is a matter for her. I certainly rest by what I said in connection with that amendment. This amendment concerns a wholly different matter. As I said to the noble Baroness, Lady Jeger, subsection (2) reproduces what is available under current legislation, which is exactly what I said to the noble Baroness, Lady Masham, under the previous amendment.

On Question, amendment agreed to.

Clauses 20 to 22 agreed to.

[Amendment No. 150 not moved.]

Schedule 9 agreed to.

Clause 23 agreed to.

Schedule 10 [Repeals and Revocation]:

Lord Trefgarne moved Amendment No. 150A:

Page 69, line 22, at end insert—

("1968 c. 46. Health Services and Public Health Act 1968. In section 48(2). in paragraph (a), the word "the Area Health Authority within whose area or" and in paragraph (b)(ii). the words "the Area Health Authority for the area".".

The noble Lord said: This amendment is consequential. I beg to move.

On Question, amendment agreed to.

Lord Lyell moved Amendment No. 151: Page 70, line 44, after ("Treasury,") insert ("and shall be").

The noble Lord said: This is a minor drafting amendment. The repeal as printed would leave Section 100(2) with superfluous words, because "shall be" would appear twice. We seek to amend the repeal so that the substantive subsection reads sensibly and properly. I beg to move.

On Question, amendment agreed to.

[Amendment No. 152 not moved.]

Lord Lyell moved Amendments Nos. 153 and 154: Page 72, leave out lines 4 and 5.

The noble Lord said: These are two consequential amendments. I spoke to Amendment No. 153 when moving Amendment No. 127; and my noble friend spoke to Amendment No. 154 earlier. I beg to move.

On Question, amendments agreed to.

Schedule 10, as amended, agreed to.

Remaining clauses agreed to.

House resumed: Bill reported with amendments.