My Lords, the Government support the euro area’s commitment to ensure financial stability of the euro area. A comprehensive and sustainable solution is urgently needed and is in the UK’s interest. This can be achieved only by the euro area working closely together. The Government also recognise the urgent need to boost growth across the EU and are pushing completion of the single market, promotion of trade, reduction in regulation and greater innovation.
My Lords, I thank the Minister and the whole Government for having shown steady and firm solidarity with our eurozone partner countries and for their strenuous efforts to solve current financial and economic problems. Does he agree that such a firm stance must be maintained to stop deep market panic despite the monumental shock of the Greek referendum decision?
I am grateful to my noble friend for recognising the constructive role which the UK Government have played in pushing forward the many strands of important discussion in the EU at the moment. I indeed agree that the agreement signed last week has to be delivered by all member states, including Greece. We will be working hard to play our part to that end.
Does the Minister agree that, in this very grave moment of crisis for Europe and for Greece, we should be urging the Greeks to recognise that, for all the inevitability of hard and painful times that lie ahead for them, it is the eurozone that is forgiving half their debts, rescuing their banks and providing the financial support to keep their economy afloat? Should the British Government not hold out a hand of friendship to Greece, for whose democracy we have a proud historical record of support, and not indulge in arrogant lecturing by a Government whose economic policies are leading to depression in this country?
My Lords, we hold out a hand of friendship to all our EU partners and to many other countries, but it is for Greece to make its own decisions. I am not going to lecture the Greeks, but it is clear that all parties to the deal last week have to deliver on their commitments.
My Lords, is it not high time that the usual channels got together and arranged for a debate in this House on the crisis in the eurozone, since we have had no opportunity other than on Statements and Questions to pursue the matter so far? In particular, should we not have some views expressed on the contingency plans which need to be made should a country leave the eurozone?
My Lords, is it not obvious to all but the most blinkered zealot that, whether the Greeks default or not, in the medium to long term the only prospect of survival for the eurozone—even that is not guaranteed—is with such a centralisation of political and fiscal ancillary powers that we would effectively have created qualitatively two different European structures? Will the Government enlighten us on what contingency planning they are making for the day that will inevitably come when that decision or those decisions have to be made?
My Lords, I do not accept the very simplistic idea that we are headed for a two-speed Europe. There is already a variable geometry in Europe in other areas apart from the euro, such as justice and home affairs, where there are different arrangements for certain member states. The critical lesson out of all this is that the UK must stick to its own fiscal deficit reduction policies because it is those which are giving us the benefit of 10-year interest rates today at 2.2 per cent, whereas countries such as Italy, which had interest rates very similar to ours before the financial crisis, have interest rates not at 2.2 per cent but at 6.2 per cent. So we must stick to keeping our own house in order.
My Lords, further to the question put by the Minister’s noble friend Lord Higgins, have the Government given any thought to the cost of returning first Greece and in due course the other crippled economies of the eurozone to their national currencies and, if necessary, supporting that transition with some variation of the Marshall plan? Have they thought about that concept, compared with continuing to throw unknown trillions at a project which cannot be saved?
My Lords, the first thing to understand is that the UK is not part of the stability mechanism that the eurozone is putting in place, and we will not contribute to specific bailouts. On the other hand, the eurozone takes about 40 per cent of our exports and it continues to be the principal interest of the UK Government to make sure that the eurozone and the whole of the EU prosper and grow, to the benefit of our own economy.
My Lords, I think that I have already done so. The two-speed Europe that people seek to paint is one between the eurozone and the rest, but thanks to the work of the Prime Minister at the 23 October Council, the very important principle was accepted that those matters which relate to all EU members and the whole of the EU, such as the single market, will of course continue to be the province of the EU 27. That is the critical acceptance which has been made by the Council and the Commission at the prompting of the Prime Minister.
My Lords, the Department of Health does not permit organisations, including general practitioner practices, to use the NHS logo to promote their non-NHS services, including private healthcare services.
I thank the noble Earl for his response, but of course most of us in the Chamber have read in the newspapers recently about the case of a GP practice writing to its patients. I believe that what happened there goes straight to the heart of general practice; that is, the relationship between the doctor and the patient. It is a relationship that I fear the Government show no sign of understanding. Will he give an assurance that the proposed form of commissioning in the health Bill will not result in the nightmare possibility of the doctor changing from the person who decides the best medical treatment for the patient to the person who decides what can be afforded?
My Lords, I can give that broad assurance, but the noble Lord will know that it is already within the GMC code that doctors have to consider the totality of the resources available to them and take account of the needs of all their patients. With that qualification, of course our reforms are designed to ensure that the highest-quality care is delivered to every patient according to his or her needs.
My Lords, is the noble Earl aware that in the 1980s, when I was president of the General Medical Council, it was unethical for doctors to advertise and those who did could be disciplined? However, I and a number of other members of the council were summoned before the Office of Fair Trading and were accused of restraint of trade. After a lengthy hearing, it was agreed that GPs should be allowed to advertise, but that consultants should not in order to preserve the gatekeeper function of a GP for access to special services. Has the situation changed?
My Lords, the issue of advertisements is slightly different from the issue surrounding logos, in particular the NHS logo. What I can tell the noble Lord is that where independent providers have their own logo and wish to use it, they can within the specifications outlined in the NHS guidelines. In cases where organisations are providing both NHS and private services, and those could include a general practitioner, then the information relating to the private services must not carry the NHS brand or logo type, and information relating to the private services must be kept separate from the NHS ones.
I have been a national health dentist. Surely the national health logo could be in the premises without necessarily being on the advertisement. It is important that practitioners should be clear on these matters. Patients want to know what services are available, whether they are national health or private and what the choices are, and it would be a deficiency on the part of a national health practitioner not to at least have information available. How can you differentiate so that it is not claimed that the NHS logo has been involved when you are basically a national health practice?
My Lords, other than for GPs, dentists and pharmacists, where use of the logo is voluntary—although it is very widely used—providers of NHS services are required to display the NHS logo as a sign of their commitment to the NHS patients that they treat. That is fine as far as it goes. However, where private services are also being delivered from the same premises, there are clear rules laid down that the NHS logo must be nowhere near any information about those services and that patients have to be absolutely clear what service they are receiving, whether it is NHS or private.
On the basis of that answer, does the noble Earl accept that it is inappropriate for an NHS general practitioner, during an NHS consultation with a patient, to offer their own private, non-evidence-based services instead of an NHS service —in other words, to offer their own private services in the context of an NHS consultation? I speak from personal experience.
My Lords, except in limited circumstances, which must be set out in their contract, primary medical service contractors—GPs, in other words—cannot directly or indirectly seek or accept from any of their patients a payment or other remuneration for any treatment. The prohibition not only relates to treatment provided under the primary medical services contract but extends to any treatment that may be provided to the patient.
My Lords, we all agree that the NHS logo must be one of the most trusted brands in the UK. It is currently outside diagnostic and treatment centres which are privately run, so can the noble Earl tell the House whether the Government will issue guidance to any qualified private providers about the use of the logo?
My Lords, perhaps I may press the Minister, following on from the question of the noble Baroness, Lady Jolly. I looked at the NHS brand guidelines website and it is most specific about the colours, size, margins, borders and even communication principles. It is silent, however, about who cannot use the NHS logo. It has a list of organisations which can use it but is silent about who cannot. Given that we may be heading towards a world with a multiplicity of providers, will the Minister undertake to look at the NHS brand guidelines with a view to making it clear under what circumstances the brand may or may not be used?
I will, of course, look at that point. However, the NHS logo is considered to be the cornerstone of the NHS brand identity. The letters NHS and the logo type are trademarks managed by the branding team at the Department of Health on behalf of the Secretary of State for Health, who technically holds the trademark. They are extremely well recognised and trusted, and use of them is very carefully controlled indeed.
Are the Government satisfied that the general practitioners in the focus of this Question were not subject to double payment—first, paid under the terms of their GMS contract for general medical services to patients on their list, and, secondly, then receiving private payments for giving the service that had already been paid for under the GMS contract?
My Lords, I have already indicated that there must be a clear separation between NHS services provided by a general practitioner and its private services—or indeed services for which it is entitled to charge that fall outside its contract. The rule is that patients should be left in no doubt about which service they receive.