Clause 32 - Reviews of pilot schemes

Health and Social Care Bill – in a Public Bill Committee at 11:15 am on 1 February 2001.

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Photo of Philip Hammond Philip Hammond Shadow Spokesperson (Health) 11:15, 1 February 2001

I beg to move amendment No. 277, in page 30, line 37, leave out `three' and insert `two'.

Photo of Mr David Madel Mr David Madel Conservative, South West Bedfordshire

With this it will be convenient to take amendment No. 276, in page 31, line 4, at end add—

`(5) The review referred to in this section must include a review of—

(a) the impact of the pilot scheme on patient services, and

(b) the cost effectiveness to the NHS of the pilot scheme, and

(c) the impact of the pilot scheme on retail competition.

(6) A report detailing the conclusions of every review under this section shall be published by the health authority concerned not less than three months after the completion of the review.'.

Photo of Philip Hammond Philip Hammond Shadow Spokesperson (Health)

Clause 32 provides for reviews of pilot schemes. That is progress indeed and has saved me the trouble of drafting an amendment requiring a review and the publication of its results. We are particularly sensitive, as the Minister will know from previous debates, to the speed with which NHS Direct was rolled out, without proper appraisal of its strengths and weaknesses. The review requirement is a good one. Does the Minister expect reviews to be conducted by outside bodies or by health authorities?

Amendments Nos. 277 and 276 would have quite different effects. Amendment No. 276 would extend the review to cover various areas, one of which we have already discussed—the impact of the pilot scheme on retail competition. It would also require an examination of the cost effectiveness to the NHS of the pilot scheme and its impact on patient services. As guardians of public services and the public purse we would all reasonably expect the review to cover those points. I hope that the Minister will agree in principle that that is necessary. Perhaps he will propose another way to achieve that objective.

Amendment No. 277 would reduce from three to two the number of years after which a review should take place. The review might take a little while to complete; amendment No. 276 proposes that a report should be published not less than three months later. If the review process did not start until three years into the scheme, publication might not happen until four years after the scheme got under way. It seems reasonable that the review should begin after the scheme had been in existence two years. That should provide enough data.

Photo of Dr Peter Brand Dr Peter Brand Liberal Democrat, Isle of Wight

Are we to assume that the retail competition referred to in amendment No. 276 would be restricted to over-the-counter medicines, rather than the wider retail activities of some pharmacists, which should not be of concern to the Committee?

Photo of Philip Hammond Philip Hammond Shadow Spokesperson (Health)

No. It is important that we consider the impact of schemes on wider retail competition. If a scheme resulted in the closure of a corner pharmacy that had also been in the habit of providing, say, milk and bread for the local community—although that might be unusual—it would be relevant and would need to be taken into account, because it would affect the community. Many pharmacists provide items ancillary to their principle business, such as baby care products. For someone in an isolated area, the closing down of the only place that sells babies' nappies will be a material consideration.

Photo of Dr Peter Brand Dr Peter Brand Liberal Democrat, Isle of Wight

I am grateful for, but surprised by, that intervention. I thought that markets would be able to cope with the supply of photographic equipment, sandwiches, clothes or suntan lotions and I do not think that that is a matter for the Department of Health or a local health authority. In view of the hon. Gentleman's clarification, I do not think that I can support amendment No. 276. Amendment No. 277 is probably not necessary.

Photo of John Denham John Denham Minister of State (Department of Health)

It is important to point out that our approach in clause 32 of reviewing every pilot scheme at least once within three years of its commencement is modelled virtually word for word on the equivalent provisions on personal medical services in the National Health Service (Primary Care) Act 1997. I do not see a fundamental reason to depart from the precedent that has been set for other family health services. The clause leaves the procedure to be determined by the Secretary of State or the National Assembly for Wales, except that it requires the health authority and pilot scheme participants to be offered the opportunity to make their views known, as part of the review. That is clearly only a minimum requirement.

It being twenty-five minutes past Eleven o'clock, The Chairman adjourned the Committee without Question put, pursuant to the Standing Order.

Adjourned till this day at half-past Two o'clock.