HC Deb 26 July 1972 vol 841 cc1957-8

"The Secretary of State shall, one month after the passing of this Act, appoint a Committee to examine and report on the possibility that the general medical and dental services of the National Health Service in Scotland be provided on the basis of a salaried service"—[Mr. Robert Hughes.]

Brought up, and read the First time.

Mr. Neil Carmichael (Glasgow, Woodside)

I beg to move—

Mr. Deputy Speaker (Sir Robert Grant-Ferris)

Order. I am sorry to interrupt on a matter of procedure, but the new Clause can be moved only by someone who has given notice. I must ask the hon. Member for Glasgow, Woodside (Mr. Carmichael) to resume his seat.

9.56 p.m.

Mr. Robert Hughes (Aberdeen, North)

I beg to move, That the Clause be read a Second time.

In Committee we discussed the question how far, within the reorganisation of the National Health Service in Scotland, we could allow for the possibility that general medical practitioners, amongst others, could be employed on a full-time salaried service. The House will be aware that in the original Measure—the 1947 Act—the position of general practitioners and others was protected, in the sense that they were laid down as being independent contractors to the National Health Service. In the past 25 years we have often discussed the question of the exact relationship between medical practitioners and the National Health Service.

The idea that general practitioners can supply the necessary services independently of the National Health Service as it now exists is remote from reality. I have been taken to task by some general practitioners for saying in a Press interview that no general practitioner in Eng- land or Scotland was afraid of full-time salaried service. I had a letter from one general practitioner, at least, who said that he was afraid of full-time service.

What I should have said—and what I think I did say—was that no generad practitioner need be afraid of full-time service. The argument has always been that general practitioners had a personal, day-to-day relationship with their patients; that they exercised individual clinical judgments, and were always afraid that the National Health Service would lead to some kind of civil service discussing every clinical judgment that they made, with some kind of overlord dealing with their patients in a way that they would regard as interfering with their professional status and with the terms of the Hippocratic oath that they took at the beginning of their service.

Mr. James Dempsey (Coatbridge and Airdrie)

Can my hon. Friend tell me whether the new Clause would provide that the usual medical kit that a doctor carries with him would be supplied, and whether that would also apply to clinical accommodation?

Mr. Hughes

My right hon. Friend raises a question about certain services that are supplied; on the one hand, the personal kit that the general practitioner carries around with him—which would in no way be involved in the terms of the Clause—and, on the other, the question of premises. The question of premises is covered in the Bill as it stands, in that premises can be supplied by the Secretary of State, with the proviso that he may recover either the whole cost or part of it. This illustrates the difficulty. We have the rather odd position that the general practitioner is to be employed as an independent contractor of an area health board, which will supply a comprehensive service—

It being Ten o'clock, further consideration of the Bill, as amended, stood adjourned.