Care Standards Bill [H.L.]

Part of the debate – in the House of Lords at 3:09 pm on 28 March 2000.

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Photo of Earl Howe Earl Howe Conservative 3:09, 28 March 2000

My Lords, in moving this amendment, I shall speak also to a further amendment tabled in my name, Amendment No. 3. Amendment No. 1 is a very simple probing amendment, the purpose of which is to clarify the meaning of "independent hospital" in the context of Clause 2. In Committee, the Minister confirmed that pay beds within NHS hospitals are subject to NHS rules. However, there is an element of ambiguity that relates to hospitals that are sited on NHS property but which are not managed or controlled by the health service. There are examples of hospitals that are owned by the NHS but which are leased to a private operator. Common sense and logic would suggest that these are "independent hospitals" and, therefore, subject to regulation by the national care standards commission. But, as we are all aware, the definitions in this Bill are orientated around physical premises. In the case of hospitals, we need to be absolutely clear that it is the management and control of a hospital, rather than where it is or who owns it, that determines the regulator.

The Minister will doubtless tell me that the meaning of Clause 2(2) is perfectly clear and that a health service hospital is defined in Clause 97 as having the same meaning as in the 1977 Act. I took the trouble to look up the definition in that Act, which reads as follows:

"'A health service hospital' means a hospital vested in the Secretary of State [for the purposes of his functions] under this Act", or vested in an NHS trust. I should be grateful for the Minister's confirmation that the potential ambiguity to which I referred--which, I should add, is a concern voiced by the BMA--is easily dealt with.

I turn to Amendment No. 3, which is another probing amendment. Clause 2(4) makes it clear that GP surgeries carrying out NHS work are exempted from the definition of "independent clinic" and will, therefore, fall within the scope of NHS regulation. However, GPs often carry out private practice work from their surgeries; for example, various types of minor surgery, laser treatment and vasectomies. These treatments frequently involve anaesthesia or sedation. There is an issue here about dual registration. On the one hand, primary care premises where private work--and only private work--is carried out will fall within the remit of the new regulatory framework. On the other hand, GP premises where NHS work is carried out are exempt under Clause 2(4). Can the Minister say whether it is correct to assume that GPs providing NHS services from their premises, where some private work is also undertaken, will not need to register with the new national care standards commission?

At present, GPs must register under the nursing homes regulations should they treat patients other than those on their own lists. Some GP practices provide services such as vasectomies to their own patients, as well as to patients of neighbouring GPs. This is a health service contract that can be paid for out of the waiting list initiative money. Can the Minister say whether, under the regime put in place by this Bill, GPs who provide NHS treatment for patients not on their own lists will need to register with the national care standards commission? I beg to move.