Clause 35 - General ophthalmic services contracts
Health Bill
12:30 pm
Andrew Murrison (Shadow Minister, Health; Westbury, Conservative)
We have heard very little from the Minister on how she will guarantee that the choice we have now will continue once these seven clauses pass into law. She has not given us the assurances that we have sought and which our amendments would have cemented into the arrangements that she is introducing. However, she opened up one or two interesting lines of debate, particularly in relation to amendment No. 29. She appears to be exercised about the quality of professionals undertaking ophthalmic services. I share her concerns; we all hope that those who provide NHS services will be high calibre and subject to audit and inspection—indeed, we look to professional bodies that register practitioners largely for that reason. That is why the amendment referred to GOS.
The Minister did not address my question about how many mavericks are out there and why she is so concerned about the possibility that people are performing sight tests who are not qualified or competent to do so, or who do not have the probity. I am not aware of any. If she is aware of any and is concerned about them, she should say so. We might then be more minded to agree with her that the amendment should be withdrawn. I am not sure, however, that she answered that question. Indeed, I am pretty sure that she sidestepped it completely.
So it appears that the PCT will be in the invidious position of determining who is of sufficient quality to undertake the contractual arrangements. That brings us back to the question that I put to the Minister during our debate on clause 34, which dealt with the cost of such arrangements. If PCTs will be expected to assure themselves that those with whom they enter into a contract are of sufficient quality, that clearly implies an inspection regime and an auditing structure, all of which requires people. Replicated across the country, that means cost.
I suspect that the £10 million-worth of fraud, which the Minister says it is so crucial to avoid that she needed to draw up these seven clauses, will be largely overshadowed by the amount of money required by the NHS to ensure that PCTs place contracts for sight tests with appropriate people. We have not heard much about that to date. It is the subject of some of the measures in proposed new section 28WF of the 1977 Act, but only very peripherally. As for GOS and the review that we hoped for, such issues ought to have been explored in the review that we thought would precede the seven clauses.