Clause 32 - Reviews of pilot schemes
Health and Social Care Bill
2:30 pm
Mr John Denham (Minister of State, Department of Health; Southampton, Itchen, Labour)
Before lunch, I was about to set out our views on the review procedure that should be adopted. The clause leaves the procedure to be determined by the Secretary of State or the National Assembly, except that the health authority and the participants in the scheme should be able to make their views known. That is only a minimum requirement. We will need to develop our approach to the review in the light of experience. We shall want to learn continuously from experience, so that we can apply those lessons to later pilot schemes and, in due course, to the substantive arrangements for local pharmaceutical services when we are satisfied that the pilots have demonstrated that LPS works. We will build reviews of individual schemes into an overall programme of review and evaluation.
Amendment No. 276 illustrates some of the difficulties of trying to put all the review criteria in the Bill. It is interested in retail competition in the widest sense, but not in the effects that the pilots have on people's health, which is an intriguing factor. Cost-effectiveness has been mentioned, but not reductions in inequalities between different sections of the community. I am not saying that the hon. Member for Runnymede and Weybridge (Mr. Hammond) is not interested in such wider issues, but it is difficult in practice to put in the Bill a comprehensive list of all the factors that should be taken into account in the review. We might want to look at others, such as the effect on the recruitment, retention and motivation of pharmacists or the relationships between different parts of the national health service.
One issue that we would want to consider is the extent to which the pilot had achieved its stated aim as set out in the original LPS contract. That will be a good starting point in many reviews. The personal medical services legislation on which we based the measure did not set out the evaluation criteria, for the good reason that it was considered then—as we consider now—that we need to build up our idea of what the review should contain in the light of experience.
As for whether reports should be published on all pilot schemes, there is no such requirement in connection with each and every PMS scheme and I am not persuaded that we need to treat pharmaceutical services differently. Of course, we shall want to learn lessons from pilots, make them widely available and disseminate them. In the case of personal medical services, we have commissioned a continuing evaluation of PMS pilots, which is published from time to time. It has informed our thinking on the third wave of PMS pilots. I am sure that there will be continuous feedback about LPS, but I do not believe that it would be a good idea to put into primary legislation a particular way of doing so or that a report should be published on every individual pilot.
Under amendment No. 276, the review would be undertaken within two years. I understand the hon. Gentleman's argument, but in reality it may take some time for a new pilot to build up to its full effectiveness. If we said that the review had to be completed within a couple of years, there may be only a year or a little longer on which to base it. The wording of the current clause, which is the same as that on personal medical services, is the probably the best route to take.