Draft Report (Top-up fees), proposed by the Chairman, brought up and read.

Ordered, That the Chairman's draft Report be read a second time, paragraph by paragraph.

Paragraphs 1 to 77 read and agreed to.

Paragraph 78 read as follows: "Although the Department was confident that its final guidance to NHS trusts would enable the separation of NHS and private care, one witness told us that in practice "it would be a little naive to believe that there would be complete separation". We believe that separation will be harder to achieve in practice than the Department claims. We are very concerned that two patients with the same condition on the same NHS ward might receive different treatments because one patient could afford it and the other could not. This must not be allowed to happen."

Amendment proposed, to leave out from "claims" to the end and add: "We believe it would be wrong for very seriously ill patients to be moved from an NHS ward to a different location so as to administer a privately paid for drug separately. This undoubted disruption to a patient's quality of life just to meet some bureaucratic requirement would not only endanger the patient's care but would be unjust. Wherever possible a drug that is being purchased privately as an addition to NHS treatment should be administered in the location best suited for the patient's well being. We agree with Sir Len Fenwick, the Chief Executive of Newcastle Hospitals Foundation Trust: "patients first, bureaucracy second." .— (Mr Peter Bone)

Question put, That the Amendment be made.

The Committee divided

Ayes, 1	Noes, 5
Mr Peter Bone	Charlotte Atkins
	Sandra Gidley
	Dr Doug Naysmith
	Dr Howard Stoate
	Dr Richard Taylor

An amendment made.

Paragraph 78 as amended, agreed to.

Paragraphs 79-80 read and agreed to.

Paragraph 81, read as follows: "We are concerned that the affirmation of the guidelines regarding the separation of NHS and purchased drugs will establish a precedent that would open up the possibility of a "core service" emerging in the NHS obliging patients to co-fund aspects of their treatment or to go without. We reinforce Professor Richards' call on the Government to clarify its policy on the separation regarding unfunded non-drug interventions including devices and procedures."

Amendment proposed to leave out this paragraph and insert:. "It is unclear what arrangements apply to the separation of NHS and private care in relation to non-drug interventions, including devices and procedures. We reinforce Professor Richard's call on the Government to clarify its policy on this." — (Mr Peter Bone)

Question put, That the Amendment be made.

The Committee divided

Ayes, 1	Noes, 5
Mr Peter Bone	Charlotte Atkins
	Sandra Gidley
	Dr Doug Naysmith
	Dr Howard Stoate
	Dr Richard Taylor

An amendment made.

Paragraph 81 as amended, agreed to.

Paragraphs 82 to 121 read and agreed to.

Summary agreed to.

Motion made, and Question proposed, That the report be the Fourth Report of the Committee to the House.—(The Chairman)

The Committee divided

Ayes, 6	Noes, 1
Charlotte Atkins	Mr Peter Bone
Sandra Gidley
Dr Doug Naysmith
Dr Howard Stoate
Mr Robert Syms
Dr Richard Taylor

Resolved, That the Report be the Fourth Report of the Committee to the House.

Ordered, That the Chairman make the Report to the House.

Ordered, That embargoed copies of the Report be made available, in accordance with the provisions of Standing Order No. 134.

Written evidence was ordered to be reported to the House for printing with the Report.

[Adjourned till Thursday 7 May at 9.30 am