Clause 25 - Supplementary lists
Health and Social Care Bill
4:15 pm
Mr Philip Hammond (Runnymede and Weybridge, Conservative)
In principle, we do not have any problems with the Government amendments. We accept that there is a need to ensure that locum GPs and non-principal GPs are properly covered by all the rules and regulations and are subject to the same kind of scrutiny as principal GPs. When I read the clause, I suspected that the phrase
persons approved by the Health Authority for the purpose of assisting in the provision of general medical services
might have a precise, technical meaning. However, that meaning is not explicit in the Bill. The lady who makes the tea for the nurse who assists the doctor who delivers the general medical services could be regarded as
assisting in the provision of general medical services.
Can the Minister tell me where to find definition of who is and who is not a person
assisting in the provision of general medical services
given that cursory glance through the amended 1977 Act has not furnished me with that information? For the moment, I will take it that, as stated, it is clear that the measure applies only to doctors and not to any other employee or any other person who assists in the provision of general medical services.
The hon. Member for Isle of Wight and my hon. Friend the Member for New Forest, West (Mr. Swayne) both mentioned nurse-led practices, but the issue extends further than that. More and more of the services that comprise GMS and are provided to patients in the general practitioner's surgery are and will continue to be provided by nurses or persons other than qualified medical practitioners. The Government are encouraging that trend and I expect them to continue to do so, because it makes sensible use of scarce manpower, but it raises the question of why nurses are not to be regulated in a way similar to that in which GPs are to be regulated.
There is no doubt that in some places nurses provide services that in other places are provided by employee or principal doctors. Some patients will be treated in a given way by a person who has to be on a list, and others going into a similar surgery in another place will be treated in the same way but by a nurse, who does not have to be on any list. The Minister may be unable to deal with that problem immediately, but he will probably agree that, as the barriers between what medical practitioners and other practitioners do are broken down, there will be a need to do so.