Personal Injuries (NHS Charges) (Amounts) Regulations 2006

I am grateful to the noble Earl, Lord Howe, and the noble Baroness, Lady Neuberger, for their comments and general support, if not enthusiasm. In relation to the comments from the Merits Committee, I, too, very much welcome (a), the fact that the silo mentality seems to have disappeared and (b), that the Merits Committee noted that. Both noble Lords understandably raised the issue of the employers’ liability compulsory insurance market. The Department of Health and the Department for Work and Pensions have been liaising closely on the introduction of the injury costs recovery scheme and the ELCI market. The Government, as the noble Earl pointed out, agreed to delay the introduction of the scheme until a study had been carried out. The final report was published in December 2003 and recommended that the implementation of the scheme be delayed for a further year. A further consultation at the end of 2004 raised further concerns about the planned timing for introducing the ICR scheme, as the ELCI market was still considered to be fragile. However, after further discussions with the Department for Work and Pensions, which was developing a programme of work to implement the recommendations of the earlier study, Ministers agreed to a further postponement of the scheme’s implementation until October of this year, to enable the programme of work to bed in. That has now happened and information from the Association of British Insurers is that increases in premiums in 2004 are, on average, between 15 per cent and 20 per cent, compared with between 30 per cent and 50 per cent in 2003. We estimate that the impact of the introduction of the scheme will be to increase premiums by 1.5 per cent, rather than the2 per cent mentioned by the noble Baroness, and that estimate has been confirmed by the Association of British Insurers. To recap, we have been working closely with ELCI, and it is confident that the scheme will not be an undue burden and can be implemented. The noble Earl, Lord Howe, implied that this is a stealth tax. It is not a stealth tax; rather it removes from the general taxpayer the burden of meeting some of the costs of treatment of the victims of other people’s negligence and places the burden on the wrongdoer. Why should the man or woman in the street have to pay for the medical treatment of someone injured at work because their employer failed to take adequate steps to protect them? The Department of Health currently pays the compensation recovery unit £2.2 million for administering the road traffic scheme. Under the expanded scheme, it is estimated that the CRU will be handling significantly more claims. Running costs, including staff costs,are expected to be only slightly higher—around£2.4 million—than for the road traffic recovery scheme. I noted the concern expressed about the Compensation Recovery Unit, and I assure noble Lords that the implementation of the income contingent repayment scheme will be carefully monitored from the outset. Its success in terms of achieving policy objectives will be reviewed by the Department of Health not less than two years after implementation. It is likely to be at least that long, possibly longer, before the scheme is fully embedded so that its success can reasonably be assessed. We believe that the CRU offers the best value for money in recovering central government moneys from compensators. It has a proven track record, electronic communications with all NHS trusts and, increasingly, with compensators. As part of central government, it has tight financial and information security requirements. There are no plans to put that work out for tender. I should add that the CRU’s IT system is very good. Quite astonishingly for a government department, it recently received a prize for its technological output and the service it gives to those using it. I note the deep concern expressed by the noble Earl and the noble Baroness about NARTRACC. I do not have any details that I can give the noble Earl today, but shall write to him at the earliest opportunity and will copy the letter to the noble Baroness. A question was asked about how we calculatethe charges. We have used a simple tariff based onthe average costs of people needing treatment for traumatic injuries, as with the existing scheme. The flat-rate charge for treatment without admission will include an amount towards the cost of any repeat attendances. A single one-off payment where hospital treatment is provided without admission will be £505. The daily rate for treatment with admission also includes an element towards follow-up appointments. Ambulance costs will be levied on a one-off payment per journey basis. I note the comments of the noble Baroness about the £159, but that is an average cost for traumatic injuries, not for all ambulance injuries. We are using a tariff rather than calculating each treatment, because it makes the scheme simpler and more economical to run. Will householders have to pay if someone is injured on their premises? Any person who pays compensation to an individual, including private citizens, will become liable for repaying any associated NHS hospital and ambulance costs. However, if the person does not or cannot pay compensation, the NHS costs cannot be recovered. Many householders may find that they have some public liability insurance cover as it is often included in home buildings and contents insurance polices. I think I have dealt with most of the questions raised, apart from that on NARTRACC, which I will write to the noble Earl about. If I have missed anything, or there is anything further noble Lords would like, I shall try to respond. If not, I will respond in writing.