Patient Services (Hansard, 12 December 1989)

§ 3. Mr. David Nicholson
To ask the Secretary of State for Health whether there has been any experience within the National Health Service of using contracts for patient services.

§ 18. Mr. Amos
To ask the Secretary of State for Health if he will make a statement on the use of contracts for patient services within the National Health Service.

§ The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman)
We believe that about 60 per cent. of health authorities have used contracts to obtain patient services from the public and private sectors. As part of the development work to prepare for the implementation of "Working For Patients", the Department is currently supporting projects working on various aspects of contracts.

§ Mr. Nicholson
My hon. Friend will recall that yesterday's debate and my contribution to it emphasised the importance of raising quality and standards in the National Health Service as it moves forward. Will he confirm that contracts placed by district health authorities will have to take account of service standards and quality of care as well as cost? Does he agree that they will enhance the power of general practitioners, as they will be consulted and the new system will have to reflect their referral patterns?

§ Mr. Freeman
I very much agree with my hon. Friend—[Interruption.] It is no great surprise. A great advantage of contracts is that the health authorities, which will be responsible for drawing them up, will be able to specify quality targets for the supply of not only hospital services but community health services.

§ Mr. Amos
Will my hon. Friend confirm that, under the proposals to improve the Health Service, district health authorities such as those in Northumberland would be obliged to maintain a reserve of resources to meet the demands of special cases? Will he confirm that that will satisfy the criteria relating to GPs' freedom of referral and patient choice?

§ Mr. Freeman
I can confirm that. We expect health authorities to begin consulting GPs about the existing referral pattern of their patients now, so that the authorities can draw up contracts reflecting that pattern. Given that referrals may take place outside the contract 832 pattern, a contingency fund will be provided in all health authorities—including those in my hon. Friend's constituency—to cover such non-contractual referrals.

§ Dr. Kim Howells
How are local health authorities supposed to place contracts with anyone when they are in a position like that of the authority in my constituency? It has already spent £1.5 million over its budget, and is so desperately short of resources that it has no beds for victims of the current flu epidemic.

§ Mr. Freeman
My right hon. and learned Friend the Secretary of State recently announced an increase of 8.4 per cent. in cash terms for the hospital and community health services next year. That is a substantial increase in the resources available to district health authorities. After April 1991, health authorities will have the job of placing contracts to acquire health services, and they will have the resources to do that.

§ Mr. Nicholas Brown
Given his previous answer, will the Minister join me, and a consultant at the Freeman hospital in my constituency, in condemning as wild and bizarre the decision to spend about £200,000 transferring heart patients from that centre of excellence in Newcastle to Wythenshawe in Manchester? What a waste of money. Should not the money be invested in the region?

§ Mr. Freeman
As I am sure the hon. Gentleman knows, that is a supra-regional service. People who require complicated heart operations should not necessarily seek service within their own districts; such complicated and expensive treatment should be provided as quickly as possible wherever it can best be provided.