HL Deb 17 June 1999 vol 602 cc425-6

2 Clause 2, page 2, line 25, after ("Act") insert ("(including this section)").

Baroness Hayman

My Lords, I beg to move that the House do agree with the Commons in their Amendment No. 2. In doing so, I shall speak also to Commons Amendments Nos. 3 to 9, 16 and 17, 20 to 23, 73 and 74, 95 to 97, 101, 103, 105 and 106, 108 to 110 and 118. It sounds worse than it is!

This group of amendments is a mixed bag of technical, consequential and drafting amendments and one or two other more substantive changes. I am afraid that they are all none the less essential. The common theme is that they each, in part at least, relate to primary care trusts and they all serve, albeit modestly, to tidy up and improve the Bill.

The amendments in this group can be broadly considered under three headings: some important amendments concerning the role of primary care trusts regarding Primary Care Act pilot and permanent schemes; a group of amendments which tidy up the provisions in the Bill which deal with the delegation to and exercise of functions by health authorities, special health authorities and primary care trusts; and a rather more disparate group of technical and drafting amendments.

I turn, first, to the amendments concerned with the primary care Act, Commons Amendments Nos. 9, 20, 73, 74 and 105. The primary care Act 1997 introduced a new option for the delivery of family health services and provides for primary care professionals to provide personal medical services and personal dental services under agreements with their health authority.

Clearly it is important to carry forward the capacity to innovate and to improve services which this Act allows into the new world of primary care trusts. At present, health authorities manage primary care Act pilot contracts. In future, however, this function may be better exercised by primary care trusts. Primary care trusts will have a detailed knowledge of the primary care services and providers at a local level, and that is what is required to get the best out of any contract, benefiting both the primary care professionals and their patients.

The Bill already makes provision for primary care trusts to be able to take on the role of providing personal medical services and personal dental services under the Act. The Bill also already provides for health authorities to delegate their functions in respect of primary care Act medical and dental pilots, including the function of contracting with service providers.

Commons Amendment No. 9 sets out the circumstances in which health authorities may not delegate their functions in respect of primary care Act pilots and makes provision for the transfer of rights and liabilities where parties to the contract change. The Bill currently makes it possible for primary care trusts both to provide personal medical services themselves and to contract for personal medical services in place of the health authority.

I think we would all agree that it would be inappropriate for primary care trusts to manage a contract for services which they were also involved in providing. Commons Amendment No. 9 specifically prevents that from happening. It also limits the delegation of other functions in respect of personal medical services where a possible conflict of interest might arise. It provides that a health authority will not be able to delegate to a primary care trust the function of turning personal medical services applications into formal proposals to the Secretary of State. This includes acting as the recipient of applications and undertaking the formal local consultations. Nor will it be able to delegate the payment of funding to meet applicants' preparatory costs.

Commons Amendments Nos. 20 and 105 are consequential on these provisions and Commons Amendments Nos. 73 and 74 make similar provision in respect of Scotland.

A large number of the amendments deal with the delegation of functions to and the exercise of functions by health authorities, special health authorities and primary care trusts. These are technical amendments, Commons Amendments Nos. 16, 17, 21, 22, 23, 97, 106, 108 to 110 and 118, which tidy up and streamline the provisions of the Bill. I do not intend to take up the time of the House in describing them unless noble Lords wish to raise specific questions.

I shall also try to be brief on the disparate group of technical and drafting amendments, Commons Amendments Nos. 4 to 8, which clarify the Bill's provisions concerning the provision of services by primary care trusts. Together they make clear that the goods and services which a primary care trust may provide to another NHS body include accommodation. Commons Amendments Nos. 95 and 96 make minor drafting changes. I beg to move.

Moved, That the House do agree with the Commons in their Amendment No. 2—(Baroness Hayman.)

On Question, Motion agreed to.

Lord Renton

My Lords, as the noble Baroness said in her rapid but careful summary of this vast list of mainly drafting and technical amendments—

Lord Hunt of Kings Heath

My Lords, we have now agreed to Commons Amendment No. 2.

The Deputy Speaker (Lord Skelmersdale)

My Lords, perhaps I may help. If the noble Baroness, Lady Hayman, would like to move Commons Amendment No. 3, the noble Lord, Lord Renton, could speak to it.