HC Deb 12 December 1989 vol 163 cc836-8
9. Mr. Win Griffiths

To ask the Secretary of State for health when he last met the representatives of the British Medical Association; and what was discussed.

12. Sir Fergus Montgomery

To ask the Secretary of State for Health when he last met representatives of the British Medical Association; and what was discussed.

Mr. Kenneth Clarke

I last met representatives of the British Medical Association on 18 October, when we had a friendly and constructive discussion about the implementation of our proposals in the White Paper "Working for Patients".

Mr. Griffiths

Is it not a shame that the right hon. and learned Gentleman will not face up to the truth—that his proposals, which are causing the BMA and virtually every other medical organisation anxiety, are just a smokescreen for underfunding the service? He says that he is spending much more, but that means nothing to patients who are sent home with life-threatening diseases. In my constituency, a patient with cancer of the oesophagus was sent home three times because an intensive care bed was not available for him. Will the right hon. and learned Gentleman provide more money for medical staff rather than for more administrators, which is what his scheme envisages?

Mr. Clarke

We are providing money for the NHS on an unprecedented scale. Neither the British Medical Association nor anyone else has put it to me recently that underfunding is the sole problem. We have just announced an increase for next year which is 5 per cent. ahead of inflation. That represents an increase in funding during the past two years of more than £5 billion.

My discussions with the BMA concentrate on ways in which we might spend that money more sensibly and carefully to get the best for patients, to cut waiting lists and to improve on facilities the lack of which, of course, are still encountered because of the way in which the NHS is run at the moment.

Sir Fergus Montgomery

Does my right hon. and learned Friend recall that, at a previous meeting with the BMA, he managed to get it to admit that it had misled the public about indicative drug budgets? In view of his great success at that meeting, will he arrange others in the hope that the BMA will withdraw other scare stories that it has put about?

Mr. Clarke

The claim that some people might not get the drugs they needed caused more alarm among patients than any other allegation made last summer. I share my hon. Friend's feelings about the fact that that allegation has been disposed of.

Meetings with the BMA are now much more friendly and constructive. Now that the House has given the National Health Service and Community Care Bill a Second Reading, I trust that everyone who shares our enthusiasm for the NHS will get down to sensible talks about how best to implement the reforms to get the best out of them.

Mr. Ieuan Wyn Jones

Does the Secretary of State agree that not one general practitioner practice in Wales which would qualify under his proposals has indicated any desire to have its own budget? Does he agree, therefore, that the central plank of his proposals are utterly irrelevant to Wales?

Mr. Clarke

It is not the central plank of the proposals, although it is an important one. I intend to give details of the programme for GP practice budgets tomorrow. That will be the first time we invite general practitioners seriously to decide whether they are interested in proceeding with it. I cannot believe that general practitioners in Wales will be more backward than their English colleagues in considering the advantages of the scheme. The more go-ahead practices which are anxious to develop services for their patients that the GP wishes to provide will be interested in the proposals I shall be putting forward.

Dame Jill Knight

Did not the BMA spend some £3 million of its own money on peddling what it has now admitted to be misinformation? In his talks with the BMA was my right hon. and learned Friend able to suggest that it should now spend a further sum on setting the record straight?

Mr. Clarke

Certainly the BMA spent a great deal of money—at least £3 million. It is now organising a fundraising campaign to replenish its war chest, but I do not think that it intends to go in for the same advertising again. That advertising campaign has virtually ceased. I think that that is because the BMA has decided to improve the climate and get down to sensible and constructive discussions that we have been trying to encourage throughout

Mr. Robin Cook

In this new friendly atmosphere with the BMA, will the Secretary of State listen to the concern that it has expressed today about the 45 patients who have been transferred from the Freeman hospital in Newcastle to the Wythenshawe hospital in Manchester simply because it is cheaper? Is he aware that there is spare capacity at Wythenshawe only because it has run out of money to treat its own patients? How can he possibly justify shipping patients halfway across England to a hospital with an even longer waiting list? Does that not reveal the dangers of a Bill that puts the price of contracts before the patients' choice?

Mr. Clarke

The hon. Gentleman refers to the unreformed National Health Service. The hon. Gentleman has discovered that quite a lot of patients move around the country, and sometimes have to travel considerable distances. They do so because patients and doctors are prepared to allow patients to travel to a better or quicker service. The Bill seeks to extend that opportunity to patients who are willing to travel for a better and cheaper service. I assume that the hon. Gentleman is talking about a nationally arranged service where the location of services is decided by the supra-national committee. If he is not, I shall look at the 45 cases, but I am quite sure that the consultants or doctors in charge of those patients decided to move them to somewhere where good quality service was quickly available. But it is quite wrong to seek to intervene in that politically.

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