§ 2.46 p.m.
§ The Question was as follows:
§ To ask Her Majesty's Government whether they will arrange for Ministers and officials of the DHSS to meet with officers of the newly-formed Doctors' Wives' Association, to discuss ways of resolving the dispute over the reimbursement of costs of employment of doctors' wives on qualifying duties in medical practices.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)No, my Lords. We are familiar with their proposals.
Lord WinstanleyMy Lords, I thank the noble Lord for that not wholly helpful Answer. May I ask the noble Lord whether he thinks it right that the Government should continue with an arrangement whereby, if a doctor marries one of his practice employees, his practice nurse, receptionist or manageress, he suddenly forfeits a substantial part of his income? Is that the kind of inducement that a Government wedded to Victorian values wishes to continue? If the noble Lord's anxiety about this matter is the question of possible abuses if reimbursement is extended to doctors' relatives, is he aware that the Family Practitioner Committees now scrutinise most carefully the qualifying posts (the posts which qualify for reimbursement in general), whether related to the doctor or otherwise? The Family Practitioner Committees assure me that they can make absolutely certain that there will be no abuse if the Government extend this to doctors' wives. Will the noble Lord meet these ladies?
§ Lord GlenarthurMy Lords, the present system may seem unjust to the noble Lord. In principle, the relatives of general medical practitioners should be treated in the same way as unrelated ancillary staff, but in practice it is not possible to do this without introducing what is (despite the noble Lord's remarks) 568 an unacceptable risk of abuse of public money. I suggest that the best way forward is for the association to speak to the General Medical Services Committee of the BMA.
§ Lord Jenkins of PutneyMy Lords, will the noble Lord advise the noble Lord, Lord Winstanley, that if he wishes to persist he can change the name of the organisation to "Doctors' Spouses' Association", because the husbands of woman doctors are surely equally entitled to benefit from any advantages they may gain?
§ Lord GlenarthurMy Lords, I am sure the noble Lord, Lord Winstanley, will note the noble Lord's remarks.
§ Lord KilmarnockMy Lords, is it not extremely easy to assess whether a wife is fulfilling a genuine ancillary role?
§ Lord GlenarthurMy Lords, perhaps the noble Lord will explain how he proposes that that should be done.
§ Lord GlenamaraMy Lords, as the Government long ago admitted this principle in the case of the wives of Members of Parliament who act as their husbands' secretaries, why not admit it for doctors' wives?
§ Lord GlenarthurMy Lords, the point about Members of Parliament is another question.
§ Baroness Masham of IltonMy Lords, is the noble Lord aware that in 1960 I moved an amendment to the National Health Service Act, which your Lordships accepted, to allow wives to work in doctors' practices? It has only to be implemented.
§ Lord GlenarthurYes, my Lords; but there are difficulties, as the noble Baroness will be aware. We are always prepared to consider positive and realistic proposals on this issue from wherever they arise, particularly where improved efficiency and better value for money are concerned. Nevertheless, any negotiations relating to general medical practitioners, including the reimbursement to doctors of the cost of employing their wives in their surgeries, are currently conducted between the department and the General Medical Services Committee of the BMA as the representatives of the general medical practitioners' interests. That is the way forward.
§ Lord Prys-DaviesMy Lords, if there is a proven need for ancillary staff, why should not the suitably qualified wife of a general practitioner be employed by him to meet the need upon the same terms as any other person who may be employed to meet that need?
§ Lord GlenarthurMy Lords, primarily for the reasons of abuse of public money, the risk of which would be unacceptably high in the way I described to the noble Lord, Lord Winstanley. The extra cost of allowing 70 per cent. salary reimbursement even for related ancillary staff would probably come to many millions of pounds a year, and that money would be better spent in other areas of the health service.
§ Baroness PhillipsMy Lords, what would be the situation if a doctor's wife went to work for another doctor?
§ Lord GlenarthurMy Lords, in that case, as far as I am aware, she would not be ancillary staff related to the doctor for whom she was working, so she would be covered elsewhere.
§ Lord LeatherlandMy Lords, does the noble Lord agree that there is a simple answer to the problem? It is that the doctor should divorce his wife and then employ her in her capacity as a single women.
§ Lord GlenarthurMy Lords, that is not a course that I would advocate.