Report (6th Day)

Part of Health and Social Care Bill – in the House of Lords at 1:00 pm on 8th March 2012.

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Photo of Baroness Finlay of Llandaff Baroness Finlay of Llandaff Crossbench 1:00 pm, 8th March 2012

My Lords, I also have my name down on this amendment. I follow the same theme as my noble friend Lord Kakkar, who has just spoken. Good Medical Practice states:

"You must be honest and open in any ... arrangements with patients".

We have already discussed a duty of candour in relation to errors. There is also a requirement to give patients accurate information, as the noble Lord, Lord Phillips of Sudbury, has already said. Giving a patient information about what is available to them can entail informing them, for example, that other drugs are available but not currently funded by the NHS, or that clinical trials are available that they may wish to consider going into. You must answer the question, "Would I get treated quicker?", honestly and with factual, correct information.

Of course, as has already been said, such stringent criteria do not apply to hospital managements. It would easy for them to see that there is something to be gained by increasing the private patient provision. I hope that this amendment encapsulates within it, in much more sophisticated wording, the spirit that I tried to capture in Amendment 220, which I withdrew. That spirit was to state that the provision should not be to the detriment of NHS patients. That is a fundamental principle that should go right the way through. I know that my wording was inadequate.

On the perception of the Bill outside this place and among the public, there is a great deal of concern. I quote from a paper coming out tomorrow in the British Medical Journal. The beginning of the paper discusses the new clinical commissioning groups, which,

"will arrange provision of fewer government funded health services and determine the scope of these services independently of the secretary of state ... They may delegate this decision to commercial companies. The bill also provides for health services to be arranged by local authorities, with provision for new charging powers for service currently provided free through the NHS (clauses 1, 12, 13, 17, and 49), and it will give the secretary of state an extraordinary power to exclude people from the health service. Taken together the measures would facilitate the transition from tax financed healthcare to the mixed financing model of the United States".

However much one agrees or disagrees with the conclusions of a paper to be published tomorrow, I quote from it because the perception out there is that there is a threat to the NHS and the equity of provision.

I hope that the Government will be able to accept this amendment, which has been carefully worded-and drafted and redrafted-to try to make sure that that principle of equity is spelled out clearly in the Bill and not caught up with different figures, numbers, formulae and so on. The basis of equality of access to essential clinical care and treatment should be a core principle threaded right the way through, between private patients and those provided with such care and treatment for the purposes of the health service. That is a fundamental principle. We have discussed it on many occasions and many assurances have been given by the Minister. There is great merit in that principle being threaded right the way through the health service so that everyone at every level of management has to adhere to those criteria as well.