Functions of Board as Regards Withdrawal of NHS Facilities from Private Patients

Part of Orders of the Day — Health Services Bill – in the House of Commons at 12:00 am on 19th November 1976.

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Photo of Hon. Robert Boscawen Hon. Robert Boscawen , Wells 12:00 am, 19th November 1976

The purpose of the four amendments, which we support, is to ensure that the private sector gets a fair chance to set up alternative accommodation. Although subsection (8)(c) was lifted straight out of the Goodman compromise proposals almost unamended, we feel that it could be taken in any way one liked to read it. It could well be taken to indicate that the Board need pay no attention to what efforts are being made to provide reasonable accommodation outside. It could be read in exactly the opposite way to that which is intended. It is badly drafted. That is why both in Committee and in the other place we felt that the Bill would be better if that subsection were taken out.

It will be extremely hard in some areas of private facilities to replace pay beds. It may take a long time to do so, particularly in the present financial crisis. We do not want the Board in any way to start rushing the phasing out of private beds when there is a possibility that in a few years' time—when conditions may be better—the private sector will be able to set up alternative facilities in order to improve the area of choice for all patients.

Our objection to the Bill is that it limits the area of choice in health care available to the citizen. If the Government persist with both paragraphs (c) and (d), they are saying that rather than wanting separation they want total abolition of private health care.

That is the message that we wish to put across. The whole point of the compromise is to achieve separation of a continued thriving private sector of health care in the country in order to give citizens better freedom of choice to have the doctor they wish to have.

We believe that Amendment No. 26, which is an insertion into the Bill, is a reasonable one. It would be quite wrong for the Board to allow pay beds to be phased out in an area where the private sector was trying to obtain facilities in order to keep the opportunities available for private practice in that area. We do not feel that it is interfering in the judgment of a local authority for the Board to take into account that planning permission for alternative accommodation may have been obstructed.

We have had warnings, particularly by NALGO, that planning permission for alternative accommodation in respect of large hospitals over 100 beds in the London area and 75 beds outside would be obstructed. This provision should be kept in the Bill.

Amendment No. 27 is an entirely new one, of which none of us thought in Committee over all those long months, but it is very important. We want to ensure that patients continue to be able to obtain the kind of doctor or treatment that they have been used to outside the NHS, once separation has taken place. That is a reasonable attitude. If a large number of, say, Roman Catholics in an area have been used to going to a Roman Catholic consultant who can use pay beds in an NHS hospital, the Board should ensure that there are private facilities outside where a Roman Catholic consultant can practise or is practising before pay beds in that area are phased out.

This is a blow that we should try to strike for freedom. Patients must be able to continue to choose the kind of doctor they want. It has been suggested that this is a wrecking amendment, but I do not agree. It refers to a "substantial reduction" in the freedom of patients. In other words, we want facilities offered outside similar to those which private patients in NHS hospitals were getting before. It is a good amendment and I invite my hon. Friends to vote for it.