Personal Injuries (NHS Charges) (Amounts) Regulations 2006

rose to move, That the Grand Committee do report to the House that it has considered the Personal Injuries (NHS Charges) (Amounts) Regulations 2006. 2nd Report from the Statutory Instruments Committee and 2nd Report from the Merits Committee. The noble Baroness said: For 70 years, hospitals have had the right to recover the costs of treating people injured in road accidents where the victim has been paid injury compensation. The NHS costs are borne by the compensator, rather than by the accident victim or the hospital. The principle is that those responsible for causing injury to others should pay the full cost of their actions or negligence, including the cost of treating the victim’s injuries. Under the existing Road Traffic (NHS Charges) Act 1999, the costs are recovered centrally and then paid back directly to the NHS trusts that provided the treatment. The road traffic Act scheme has so far paid some £300 million to hospitals in Britain for them to reinvest in front-line patient care. The Health and Social Care (Community Health and Standards)Act 2003 took the powers to extent recovery of NHS costs to cases involving personal injury compensation generally. It does not seem logical that the successful road traffic Act scheme should be restricted to motor accidents. Therefore, it will not be restricted to motor accidents when the new scheme comes into force early in the new year. When a person receives compensation for an injury, the costs of any NHS hospital treatment and ambulances in connection with the injury will be recoverable from whoever has paid the compensation. The income raised from the new injury cost recovery scheme will be paid straight back to the hospitals that provided the treatment. Those hospitals will be free to use the money to improve patient services as theysee fit. In that way, we hope to recover an additional £150 million to be reinvested in front-line patient care. These regulations make provision concerning the amounts of NHS charges to be recovered under the injury costs recovery scheme from people who pay compensation in cases where an injured person receives NHS hospital treatment or ambulance services. As well as setting the tariffs for outpatient and inpatient treatment, the provision of NHS ambulance services and the maximum amount to be recovered in relation to any one injury, these regulations also set out how the injury costs recovery scheme is to deal with a range of circumstances in which the amounts to be recovered may need to be adjusted. These regulations are made using for the first time powers under section 153(2) of the Health and Social Care (Community Health and Standards) Act 2003. The Act requires the first regulations made under these powers to be subject to the affirmative resolution procedure. The Act also requires the Secretary of State to consult the National Assembly for Wales before making regulations under Part 3 of the 2003 Act. As these regulations are made under Part 3, consultation has taken place. The noble Lord, Lord Warner, has made the following statement regarding Human Rights: "““In my view the provisions of the Personal Injuries (NHS Charges) (Amounts) Regulations 2006 are compatible with the Convention rights””." Part 3 of the Health and Social Care (Community Health and Standards) Act 2003 makes provision for the establishment of a scheme to recover the costs of providing treatment to an injured person where that person has made a successful personal injury compensation claim against a third party. The injury costs recovery scheme builds on the existing scheme introduced by the Road Traffic (NHS Charges) Act 1999—the RTA scheme—which allows costs to be recovered in road traffic accident cases only. The new injury costs recovery scheme will come into force on 29 January 2007. The injury costs recovery scheme will be administered by the Department for Work and Pension’s Compensation Recovery Unit—CRU—on behalf of the Secretary of State for Health. The CRU has operated the current RTA scheme since 1999, and has extensive links with, for example, solicitors and insurers. The person found liable to any extent in respect of the injury will also be liable to pay the relevant NHS charges in respect of NHS hospital treatment and ambulance services, in so far as provided. Compensators will have a legal obligation to inform the CRU of any claim for personal injury compensation. Under the existing RTA scheme the amounts to be recovered are set using a simple tariff system. The tariff consists of a single one-off payment where hospital treatment is provided without admission, currently £505, or a daily rate, currently £620, for each day or part day of admission to hospital, excluding the day of discharge. There is also a statutory ceiling on how much can be recovered in relation to treatment of injuries resulting from any one incident—currently £37,100, or roughly 60 days’ in-patient treatment. These amounts have been migrated to the injury costs recovery scheme, with the addition of a new element to cover the cost of any ambulance journeys that may be required. This has been set at £159. Regulation 2 of these regulations sets out the amounts of NHS charges payable. The tariff system means, of course, that frequently the amounts recovered do not match exactly the costs of providing treatment in any specific case. The tariffs represent average treatment costs; all these amounts have been established by calculating the average cost of treatment for injuries typically suffered in accidents and, for ambulance journeys, the average costs of providing ambulance services. These amounts are not intended to provide exact reimbursement. Under the RTA scheme the tariffs are uprated annually on 1 April in line with NHS inflation. The increase is calculated using an average amount based on the three most recent years for which figures are known. The intention is to retain the annual uprating exercise but the tariff will not be uprated on 1 April 2007, given that the scheme will only recently have been introduced. These regulations also set out how the ICR scheme is to deal with a range of circumstances where the amounts to be recovered may need to be adjusted. For example, the regulations make provision for where more than one person is liable to pay the NHS charges in respect of the same injury. Regulation 5 provides for the liability to pay the charges to be apportioned by the Secretary of State between two or more compensators. Naturally, there has to be adjustment for cross-border cases. Regulation 6 covers the adjustment of a certificate of NHS charges where the Secretary of State and Scottish Ministers both issue certificates. This could apply, for example, when an injured person has received treatment in both a hospital in England and a hospital in Scotland. If the amount specified in the certificates when aggregated exceeds the maximum amount—currently £37,100—the Secretary of State may adjust any amount specified in the certificate issued by her. Regulations 7 to 10 make provision for the repayment of overpayments of charges and the recovery of underpayment of charges, including provision requiring the Secretary of State to send out statements showing the amount of overpayment or underpayment and the action required. If, as a result of a redetermination, adjustment, review or repeal, it appears that the amount of NHS charges paid by any person is more than the amount that ought to have been paid, the Secretary of State will either pay the difference to the person who paid the NHS charges, or instruct the trust or body to pay the difference to the person who paid the NHS charges. Where the Secretary of State pays the difference, she will instruct the relevant NHS body to pay the difference to her or deduct it from future payments to that NHS body. If it appears that the amount of NHS charges paid by any person is less than the amount that ought to have been paid, the person who paid the relevant NHS charges will pay the difference to the Secretary of State, who will then pay that difference to the relevant NHS body. Where an underpayment or overpayment occurs, the Secretary of State will send a statement to the person paying NHS charges and the relevant NHS body, setting out the details, including details of the revised amount of NHS charges. In summary, these regulations extend the scheme that allows the NHS to recoup the cost of treating the victims of road traffic accidents to include all cases where an injured person has made a successful claim for personal injury compensation. I beg to move. Moved, That the Grand Committee do reportto the House that it has considered the Personal Injuries (NHS Charges) (Amounts) Regulations 2006. 2nd Report from the Statutory Instruments Committee and 2nd Report from the Merits Committee.—(Baroness Royall of Blaisdon.)