Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

This is a brief clause, and I suspect that it is of a technical nature. It deals with schedules 3 and 4. As the Opposition clearly do not have the formidable civil service research capability that is available to the Minister, there is a risk that measures that may have implications for the Bill might be slipped in unbeknown to us. I am flicking through the list of Acts that are going to be amended or repealed as a result of the Bill, and I wonder what the implications are. I hope the Minister will not pass the clause without making any comment. Perhaps she could give us a résumé of the measures that are being repealed or amended. It is an extensive list of changes, so will she assure us that there will be no negative effects through the changes proposed under the clause?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I will do my best.

The amendments and appeals are all consequential on the creation of the agency as a non-departmental public body from its predecessor bodies, with one exception. The exception is the amendment of paragraph 3 to schedule 3. That will allow the Secretary of State to direct his function of

appointing medical inspectors under the Immigration Act 1971, which is also exercisable by persons specified in the direction who exercise functions in relation to health in England or Wales. That delegation takes account of the fact that the arrangements for identifying medical inspectors are best made locally. The intention is to delegate appointments in England to the HPA—initially a special health authority and subsequently the agency as established by the Bill—and in Wales to the National Assembly for Wales. I reassure the hon. Gentleman that is the only change of any significance—it is not really a change of significance, but I draw it to hon. Members' attention. Otherwise, the matter in question is consequential on the creation of an NDPB.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am grateful to the Minister for mentioning the Immigration Act 1971. Immigration is a sensitive issue and she is right to raise it, particularly since the relevant measure stands out from the rest. Although it is consequential, it is of great importance.

What is meant by the term ''medical inspectors''? Are they the sort of medical people who are positioned at ports and airports to deal with those seeking to migrate to this country and perhaps claim asylum? If so, I am slightly concerned, because such matters are controversial. Many of us would say that medical inspection facilities at airports ought to be enhanced. We certainly need to tread warily if we are changing the legislative framework under which such inspectors operate. Could the Minister say how the proposed change might affect how medical inspection is done on the ground?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

The hon. Gentleman is right in his supposition that the medical inspectors are those who deal with the health of migrants to this country. Those medical inspectors are being singled out for the purposes of identifying who they are. Local PCTs have a huge input into port authorities' arrangements for such purposes, as I am sure that he is aware. Essentially, the provisions do not change the situation and still provide the existing flexibility. On some occasions, appointments and the identification of those who might carry out the role are best made locally.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I would be interested to know how the appointments are made now, as I am a little unclear about that. I agree that appointments are best made locally. I suspect that most appointments will generally be local doctors. Is the Minister saying that that will change? I am a little unclear about that. In her previous remarks, she seemed to suggest that the agency would still make the appointments, but we now understand that they will be made locally. Does that mean by the PCT? If so, that will cause difficulties in places such as Heathrow, which I suspect might cover more than one PCT—it is such a vast site that that is almost certainly the case. The same is probably true of other ports and airports. If PCTs make the appointments locally, as I think the Minister said, how does that pan out in places such as Heathrow?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

The point is that the HPA can appoint in future. Under the present arrangements, the

PCTs make such appointments on behalf of the Department. As I said, the HPA—initially as a special health authority and subsequently as the agency—will delegate appointments, whereas the National Assembly for Wales will do so in Wales.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am sorry to press this point, but it strikes me as important. I am glad that I asked about schedules 3 and 4, which could well have passed us by, as I said in my initial remarks. Is the Minister saying that the function will be more devolved? Many of us think that we should get a grip of such matters, and we welcome the agency because difficult and sensitive issues such as TB and HIV are being gripped centrally as part of a countrywide approach. The medical inspectorate is fundamental to that approach.

In general, we like to devolve things, and we like things to happen locally, but the Bill raises public health issues, which must be gripped and dealt with centrally. From what the Minister is saying, we seem to be moving in the wrong direction, with the agency devolving responsibility for the inspectorate. The inspectorate brings together a group of professionals who have not traditionally enjoyed the status and resources that they deserve. Unless I have got it wrong, the Minister is proposing to devolve responsibility for the inspectorate to a more local level. Indeed, the HPA might even surrender responsibilities for the service in some respects. If that is the direction of travel, we would be very concerned.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I think that the hon. Gentleman misunderstood what I said. Perhaps I can be clearer. At present, once a medical inspector is identified locally—the hon. Gentleman mentioned some of the possible arrangements—people must write to the Department of Health to obtain the Secretary of State's clearance for the appointment. In future, they will have to go to the agency, which, the hon. Gentleman will agree, will be better placed to deal with such issues, given its detailed oversight and understanding of what is needed, than the Department. It will certainly be the most appropriate body to take the issue forward. If he would like me to write to him about the appointment of medical inspectors, however, I shall be happy to do so before Report.

Question put and agreed to.

Clause 11 ordered to stand part of the Bill.

Schedule 3 agreed to.

Schedule 4 agreed to.