Clause 27 - PMS and PDS lists
Health and Social Care Bill
5:30 pm
Mr Desmond Swayne (New Forest West, Conservative)
The purpose of clause 27 is to extend the health authority lists to personal medical services to mirror the provisions in clause 24 with respect to general medical services. There is, however, a key difference between the two clauses in that under clause 24, the Secretary of State is required to
consult such organisations as he thinks fit appearing to him to represent medical practitioners providing general medical services.
In effect, that means the general practitioners committee of the BMA. He has to make that consultation before he makes the regulations.
In clause 27, there is an omission with respect to the regulations being made for personal medical services, in that there is no requirement to consult in the same way. What is sauce for the goose should be sauce for the gander. We have lifted the wording of our amendments directly from the provision in clause 24. Members of the Committee may have spotted that, so eager were we to use the exact words of the Bill, we left a small inconsistency in the wording of the amendment—a drafting error—in that it refers to ``general medical services'', when, to be pertinent to the clause, it should refer to ``personal medical services. However, the principle is sound.
If PMS general practitioners are to have confidence in the system, it is essential for them to have the same rights and protection nationally as their general medical services colleagues. That principle should also extend to other medical practitioners, such as dentists, who provide personal medical services.
The BMA's general practitioner committee must apply itself equally to GMS and PMS issues. The BMA states:
This is a matter of fundamental importance to the BMA.
It is happy for the Government to consult others, either informally or through the Department of Health's personal medical services implementation group, but not as a substitute for negotiation with the BMA's GP committee, which is the sole recognised body for negotiating on the rights of general practitioners. That recognition predates the arrival of personal medical services.
A lack of national consultation and similar rights to those enjoyed by general medical services practitioners will cause alarm and may influence general practitioners in their stance on personal medical services. At a time when constructive co-operation is at a premium and co-operative dialogue is in everyone's interests, it is essential to minimise suspicion about personal medical services and the introduction of the clause.
Personal medical services seem increasingly to have a national dimension. The third wave and all future waves of personal medical services contracts will operate within a nationally specified core contractual framework. Paragraph 8.9 of the NHS plan states:
By 2004 both local Personal Medical Services and national arrangements are set to operate within a single contractual framework that will meet the key principles and requirements of a modern NHS.
We believe that the same negotiating framework and requirement for the Secretary of State to consult before making regulations should apply equally to PMS and GMS. Does it? A suspicion will remain if the Government do not reassure us in that respect. Is the intention to use the roll-out of PMS as a vehicle to weaken existing consultation methods with the medical profession?