COMMONS AMENDMENT (Hansard, 17 June 1999)

§ Baroness Hayman

My Lords, I beg to move that the House do agree with the Commons in their Amendment No. 11. In moving this amendment, I shall also speak to Amendments Nos. 12 to 14, 77 to 80, 100, 121, 128 and 130.

When I introduced Clause 9 at Third Reading, I explained that the purpose of what was then a new clause was very simple. In essence, it was intended to put on a sounder legal footing the existing arrangements for remunerating the Part II practitioners who provide family health services. The clause will also enable the delegation to primary care trusts of the function of determining cash-limited payments to GPs. The clause will otherwise not signal any change to the existing remuneration system for GPS, dentists, pharmacists or opticians. None the less, the clause is complex, technical and long. Those features derive from the existing Sections 43A and 43B which the new clause replaces.

432 We have chosen to retain the structure of the existing sections to help to demonstrate that the intention is to regularise and not to change existing practice. However, in considering the clause in Committee in another place, the Government and the Opposition identified a number of points in the clause that needed amendment, either to make the legal provisions fully consistent with established practice, or simply to tidy up the drafting. These amendments represent the fruits of that constructive deliberation.

The need to make the first amendment, Commons Amendment No. 11, was brought to our attention by the Opposition. Before a national determination of remuneration is made, we invariably consult the relevant representative body. That was also the practice of the previous administration. For example, before making changes to the GPs' statement of fees and allowances, we consulted the General Practitioners Committee of the BMA. However, in another place it was pointed out that the consultation requirements that paragraphs (a) and (b) of the new Section 43B(1) place on the Secretary do not quite reflect that practice.

Subsection (1) of the new Section 43B of the 1977 Act requires the Secretary of State to consult at least one of either a suitable advisory body or an appropriate representative body of the profession concerned. In practice, the Secretary of State could discharge the duty to consult by consulting an advisory body rather than a representative body. Since it is not our intention to do so we took the opportunity at Report stage in another place to make this clear on the face of the Bill. Amendment No. 11 requires the Secretary of State to consult the appropriate representative body for the profession concerned and allows consultation with others.

All the other amendments are technical or consequential and together they tidy up Clause 9. Amendments Nos. 12 and 13 provide consistent wording throughout the clause. Amendment No. 14 omits Clause 10(4) as the event for which this subsection provides cannot now occur. Amendments Nos. 77 to 80 repeat these changes for Scotland. The remaining amendments in the group, Amendments Nos. 100, 121, 128 and 130, are all minor or consequential. In particular, they secure the repeal of Section 10 of the 1966 Act for England, Scotland and Wales.