HC Deb 10 November 1992 vol 213 cc730-2
5. Mr. Bryan Davies

To ask the Secretary of State for Health what proportion of general practitioner fund-holding practices are projecting overspends in the current financial year; and if she will make a statement.

Dr. Mawhinney

That information is not held centrally, but I have no reason to believe that fund holders will be any less efficient in managing resources than they were last year.

Mr. Davies

Are not regional health authorities having to bale out those GP fund holders who are overspending? Is that to save the Government embarrassment over the failure of the scheme? Should not the resources be used for better and fairer purposes in the health service than baling out fund holders?

Dr. Mawhinney

I am sure that the hon. Gentleman will be pleased to know that, last year, overall savings were about 4 per cent.—that is to say, GPs came in at about 4 per cent. below budget. As a result of imprecision in the setting of some budgets—which I recognise and on which work is being done—a few GP fund holders needed to ask regional health authorities for special help and that was given, as the rules allow. Nevertheless, the fund holders' record in treating their patients is an enviable one for the rest of the profession to follow.

Mr. Jacques Arnold

Are not fund-holding practices now getting value for money and, above all, obtaining treatment for patients faster, co-ordinated for the convenience of those patients?

Dr. Mawhinney

My hon. Friend is absolutely right. Next April, the percentage of the population being served by GP fund holders will increase from 14 per cent. to, probably, just over 25 per cent. and, anecdotally, it is suggested that the fourth wave in the following year will be very large indeed. That reflects the attraction of the scheme not only to GPs but to their patients.

Mr. Blunkett

Would the Minister care to comment on the article in The Times this morning which suggests that 100 GP fund holders are to form a consortium with a budget of more than £20 million, which will aim to match the purchasing power of district health authorities? Does the Minister agree that not only does that not square with the district health authorities' accountability for health care planning and strategy but that it runs contrary to the ethos of GP fund-holding practices as set out by the Government, which is that they should buy individual contracts for individual patients? Does not this whole sorry story show that the Government's reforms are in a terrible mess? Is it not time that they agreed to start again and put patients first?

Dr. Mawhinney

I am happy to respond to the wisdom of the National Union of Public Employees. However many GPs enter GP fund-holding schemes in a given area, their share of the budget is only 20 per cent., so their purchasing power will not in any sense be comparable that of the district health authority. The Kingston GPs mentioned in today's edition of The Times are thinking of joining forces because, in their judgment, that is the best way to deliver the best services to their patients. If I have to choose between those GPs' judgment of what is best for their patients and the hon. Gentleman's judgment, I shall side with the GPs every time.

Mr. Paice

Is it not indicative and encouraging that many GPs, including some in my constituency, who were opposed to the principle of fund holding at the time of the NHS reforms are now applying to become fund holders because they have seen the benefits to patients of existing GP fund holders?

Dr. Mawhinney

My hon. Friend is absolutely right. The fact that 600 GPs are to join the scheme next April gives substance to his remarks. GP fund holders, through their initiatives, have been in the lead in developing better services, not just for their own patients but for all patients in their community. That should be welcomed by hon. Members on both sides of the House.