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Health and Education

I am sure that all Opposition Members will agree with the latter point; in fact, I agree with the former point as well. The proposed legislation as structured relies far too heavily on order-making powers and on the use of codes of practice, instead of the relevant provisions being included in it. The Bill does not include the principles to be applied in designing mental health services, as the Scottish legislation does. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) and his colleagues published only yesterday a document including independent contributions on the structure of the legislation, which I commend to the Secretary of State and to the whole House. I shall make one or two points about national health service redress. The Government do not appear to be considering the introduction of conditional fee arrangements in clinical negligence cases beyond the point of fact finding and investigation. I commend that approach; otherwise, there is a risk under the legislation that the process of fact finding and fault finding will simply lead either to a distortion of fact finding, because it is combined with fault finding, or to fault finding simply feeding more and more clinical negligence cases that do not necessarily have merit, but are funded through legal aid. There is a serious problem with the introduction of no-fault provision in respect of birth defects. The definitions will be intensely difficult to make and where does one draw the line—during pregnancy, with congenital birth defects, or with medical accidents occurring shortly after birth? It will be extremely difficult to deal with that problem. I have already spoken about hygiene and public health. The Government intend to introduce a provision on hygiene, which is interesting, but in the light of all that I have said about what needs to be done on cleanliness and infection control in hospitals, they hardly seem to be acting with any urgency to deliver. Indeed, they have not even acted with the urgency recommended to them by the chief medical officer, who suggested legislation to introduce enforcement powers for dealing with hygiene in hospitals. He wrote to Ministers in October last year urging legislation in the last parliamentary Session. Ministers did not act on that, but are proposing to do so now. The problem with imposing fines on the NHS and on hospitals if they do not meet hygiene standards is that it is a counsel of despair and an admission of failure. We need a successful NHS, and during the election campaign we set out clearly how we could provide specific additional help to get technologies and other forms of support through to front-line staff in order to deliver improved infection control. The Government are also proposing a partial ban on smoking in public places—a typical Labour Government approach in that the rhetoric is all there, but the actual proposal is utterly unworkable. Apart from anything else—[Interruption.] I am sorry that I neglected to mention the Minister of State, Department of Health, my hon. Friend the Member for Doncaster, Central, so I mention her now. Doncaster metropolitan borough council reported to the British Medical Association that 36 per cent. of their pubs do not serve food. If a ban on smoking in pubs is linked to whether pubs serve food, we shall end up with a large number of pubs, particularly in northern and midlands cities and in less prosperous areas, continuing to allow smoking because they do not serve food. It will not deliver the objective that Ministers want. In Leeds, 88 per cent. of pubs reported to the BMA that they did not serve food; clearly, the impact of the legislation will be to increase health inequalities.