§ Lord Molloy asked Her Majesty's Government:
§ Whether they intend to amend their proposals contained in the White Paper Working for Patients in response to the views of professional organisations including the Royal Colleges, the Confederation of Health Service Employees, the Health Visitors Association, the British Medical Association, the British Dental Association, the Association of British Dispensing Opticians and the National Association for Mental Health.
§ Lord HenleyMy Lords, we are firmly committed to our proposals set out in Working For Patients but welcome views on their implementation.
§ Lord MolloyMy Lords, I note that the entire British medical profession is opposed to the scheme. Is any body of opinion outside the Prime Minister's entourage in any way in favour of the scheme?
§ Lord HenleyMy Lords, yes. Three organisations have been broadly supportive of the proposals the National Association of Health Authorities, the Institute of Health Service Management and the Society of Family Practitioner Committees. There has also been wide-ranging support from individual clinicians, mainly hospital consultants or heads of academic departments of medicine.
§ Lord EnnalsMy Lords, does the noble Lord accept that the first two organisations that he mentioned supported some parts of the proposals but have been generally critical of them? Would it not be profoundly unwise for the Government to ride roughshod over the strongly held views of people who work daily in the National Health Service? Does he recognise that there is a massive amount of opinion against the proposals which are thought will cause grave damage? Would it not make sense to give a longer period of consultation so that views can be considered genuinely, rather than the question just being about the implementation of what the Government have decided? Is that the way to govern the country or the National Health Service?
§ Lord HenleyMy Lords, as the noble Lord will be aware, I said that many doctors have also supported the Government. The fact that the BMA has not been broadly supportive is irrelevant. We have a great deal of support from individual doctors.
§ Lord Jenkin of RodingMy Lords, is my noble friend aware that there is considerable indignation about the misleading and tendentious propaganda put out by the BMA which doctors are now being asked to circulate in their consulting rooms and surgeries? Is he aware that many doctors regard the leaflet as an insult to their patients and will not display it?
§ Lord HenleyMy Lords, I agree with my noble friend. Much of the information the doctors have been putting out on the instructions of the BMA has been wrong.
Lord WinstanleyMy Lords, are the Government wise to try to ride roughshod over two great professions—the law and medicine—at one and the same time? Does the noble Lord accept that some doctors, who are implacably opposed to the White Paper, nevertheless accept that some of the proposals could prove beneficial to doctors and patients alike, provided that they are introduced with care and after proper consultation, and, in particular, after there have been preliminary pilot studies in selected areas to find out how the proposals will work before they are finalised?
§ Lord HenleyMy Lords, I do not believe that we are riding roughshod over the two professions. With regard to the pilot schemes, thorough consideration was given to the proposals during the year in which the review was carried out. To postpone full implementation would lead to uncertainty and anxiety in the service without producing the benefits to patients and staff that will flow from early implementation.
§ Lord McCarthyMy Lords, it would be fair to say that the Government have found a GP in Hove who says that there is much to be said on both sides of the case.
§ Lord HenleyMy Lords, I can assure the noble Lord that many GPs support the Government. If the noble Lord read an article by a London GP in the Standard last Friday he would have seen that he supported the Government's case.
§ Lord RugbyMy Lords, as I am outside the Prime Minister's entourage, may I say how pleased I am that I can now buy my reading spectacles without charging the taxpayer £10 and can choose them myself for £2.99?
§ Lord HenleyMy Lords, that question goes rather wide of the subject on the Order Paper, but I thank the noble Lord for his remarks.
§ Lord EnnalsMy Lords, will the criticisms that have been made of the BMA, which do not seem to promote good relations, apply also to the Royal colleges which have been strong in their condemnation of the Government's proposals?
§ Lord HenleyMy Lords, I criticised the BMA for some of the documents it issued which were mentioned by my noble friend Lord Jenkin and which are not fair.
§ Lord Dean of BeswickMy Lords, in his reply to the first supplementary question, the noble Lord quoted the various organisations which had indicated support for a large part of the Government's proposals. He quoted the area health authorities and family practitioner committees. He must be aware that those organisations are manned overwhelmingly by government appointees whose political colour must be Conservative before they are appointed, so is there anything strange in the fact that they have come out in support of the proposals?
§ Lord HenleyMy Lords, as the noble Lord is well aware from an answer given by my noble friend Lord Arran some time ago, people do not have to be Conservative to be members of such organisations. We always choose the best possible people. The three associations that I mentioned were not those mentioned by the noble Lord. I mentioned the National Association of Health Authorities and the Institute of Health Service Management. The noble Lord did mention the Society of Family Practitioner Committees.
§ Lord MolloyMy Lords, will the organisations that the noble Lord has mentioned be allowed to submit amendments? Will the vast amount of land held by hospitals be allowed to be flogged off to whoever can afford to buy it? Is it not a fact that careful examination of the noble Lord's evasions this afternoon reveals one thing, and one thing only—that the Government's Bill is designed solely to destroy the National Health Service?
§ Lord HenleyMy Lords, that is absolute rubbish. As I said, we are firmly committed to the proposals but welcome views on their implementation. As the noble Lord knows perfectly well, and as Ministers in both Houses have repeated on many occasions, we have absolutely no plans to privatise the National Health Service.
§ Baroness SeearMy Lords, if the Government are firmly committed, what is the point of submitting our views? Following that, will the noble Lord not think again about the proposals from the noble Lord, Lord Winstanley? Surely when making a big change in any sphere there is a great deal to be said for a pilot study unless one is totally convinced that one has got it absolutely right in the first place. What evidence is there ever to suggest that one has got anything totally right in the first place?
§ Lord HenleyMy Lords, I said that we welcomed views on implementation. With regard to pilot studies, quite a few of the proposals are voluntary, such as the doctors' practice budgets. In a sense one could argue that that is something approaching a pilot study. It is up to the doctor himself to decide whether to take it on.
§ Lord AnnanMy Lords, is it not a fact that the great Minister of Health, Aneurin Bevan, also met united opposition from the profession? Is it not also a fact that Mr. Bevan was extremely subtle in his negotiations with the BMA and the other professional medical organisations?
§ Lord HenleyMy Lords, I am sure that the noble Lord is correct. As one of my noble friends said the other day, that was slightly before my time.
Lord WinstanleyMy Lords, will the noble Lord accept that no sensible general practitioner would accept the new contract unless he or she were satisfied as to how and by whom the community care would be provided?
§ Lord HenleyMy Lords, the new contract is a totally different question, and I think it is wrong to start confusing it with the White Paper.