§ The following Question stood upon the Order Paper:
§ 61. MR. PAVITT: To ask the Minister of Health whether he is aware of schemes under which some general practitioners are to make their services available in return for subscriptions and fees from their patients as an alternative to the National Health Service; whether he will ensure that no patients are deprived of free care under the National Health Service; and whether he will make a statement.
§ The Minister of Health (Mr. Kenneth Robinson)With your permission Mr. Speaker and that of the House, I will now reply to Question 61.
Yes, Sir; I have seen reports about several such schemes. I welcome the opportunity to make it quite clear that there is no necessity for any patient to join a private scheme of any kind in order to obtain proper medical care and that the normal National Health Service facilities will continue to be available for all without payment. I would deplore diversion of doctors' time to private patients which meant reduction in the time available for National Health Service patients.
§ Mr. PavittCan the Minister say what service the subscribers will get that they cannot receive under the National Health Service? Will he further say whether the B.M.A. has given its official blessing to this proposal?
§ Mr. RobinsonIt is difficult to say what the patient would get. There should be no question of the private patient getting any better treatment because under the National Health Service a doctor is required to give his patient all proper and necessary treatment. Possibly the patient expects to get a little more of the doctor's time. The British Medical Association has given its blessing to one of these schemes, known as Independent Medical Services Ltd.
§ Miss PikeWhile we are all anxious that National Health Service patients should get the best possible treatment, is the Minister aware that many of us think it important that we have an adequate choice in this respect and that therefore many of these schemes are valuable?
§ Mr. RobinsonThe hon. Lady knows that I have made my view clear on a number of occasions. It is that a substantial increase in private practice would be to the disadvantage of the vast majority of people. The hon. Lady knows that medical manpower is limited and that if private patients claim disproportionately more of the doctor's time there will be less time for the National Health Service patient.
§ Dr. John DunwoodyWould the Minister agree that there are very many family doctors who view these developments with considerable distaste? Would he further agree that if these developments continue he should seriously consider whether he ought to be able to require family doctors either to work within or outside of the National Health Service, rather than the mixed form of practice which these schemes seem to encourage?
§ Mr. RobinsonI have seen no great enthusiasm for these schemes among the general public, nor among the medical profession. I will certainly watch the position very carefully in order to see whether further action is required.
§ Dr. WinstanleyWould the Minister agree that any increase in private practice, which I regret as much as he does, is in part a reflection of the inadequacies in the National Health Service at the moment?
§ Mr. RobinsonI would not accept that. I do not accept a number of claims that are made. In one case it was said 36 that this development would help curb the emigration of doctors. I do not believe that it will have the slightest effect upon it.
§ Miss PikeIs the Minister aware that he gave an unfair slant in the answer to my question? We need to make absolutely certain that there is a proper balance in the Service, but at the same time we want freedom to have this sort of choice within the Service as a whole.
§ Mr. RobinsonI was talking about a substantial increase in private practice. It is accepted that private practice is permissible, and always has been, but I would deplore any great extension of it.
§ Dame Irene WardCould I ask the hon. Gentleman if he is aware that many people have to wait far too long for adequate service from the National Health Service? Will the right hon. Gentleman now meet the claims of these National Health Service patients for better and quicker treatment?
§ Mr. RobinsonWe are doing the best that we can, but if there are more private patients the National Health patients will have to wait a good deal longer.