HC Deb 24 January 1989 vol 145 cc853-4
1. Mr. Hayes

To ask the Secretary of State for Health what plans he has to cash-limit general practice; and if he will make a statement.

The Secretary of State for Health (Mr. Kenneth Clarke)

My objective is to achieve a good quality service for patients and value for money in general practice, as in the rest of the National Health Service. My hon. Friend may wish to await our proposals for the whole of the NHS which will be published shortly.

Mr. Hayes

As I am sure that my right hon. and learned Friend appreciates the importance of general practitioners giving value for money to the patient and the taxpayer, will he take into account that they also act as a helpful safeguard—a safety valve—for a cash-limited hospital sector, which makes it important that there be the absolute minimum of Treasury interference?

Mr. Clarke

General practice is the key to a great deal of the British Health Service's success. The general practitioner is the first person to whom a patient looks for advice for himself and his family. The general practitioner is the gatekeeper to the rest of the Health Service, deciding on referrals to the most suitable part of the service. I certainly accept the value of general practice and I am sure that our proposals, when published, will underline its crucial role and seek to support general practitioners in carrying it out.

Ms. Harman

How does the Secretary of State answer patients' justifiable fears that when general practitioners are kept to fixed budgets they will limit patient care so as to keep within the budget? Will not doctors give treatment to suit the budget rather than treatment that suits the patient, and what happens if the money runs out?

Mr. Clarke

At the moment, I am telling people with hypothetical fears about hypothetical proposals that they should wait for our full proposals to be published, together with the supporting arguments, which I am sure will set the hon. Lady's fears at rest.

Mr. Ian Bruce

Does my right hon. and learned Friend agree that the low percentage of GDP that we spend on our excellent Health Service is a measure of the value that we receive from general practitioners and their cost-effectiveness in delivering health care? Can he assure me that after the review of the NHS the general practitioners will play a leading role in delivering services to their patients?

Mr. Clarke

I agree with my hon. Friend's first point and I shall try to match up to his hopes on the second point. We have a pretty cost-effective service. One reason for that is the fact that general practitioners refer people, thus making the best use of the hospital service. I much prefer our system to that which prevail in other countries, where patients are expected to have individual specialists for whatever complaint they think that they have, and thus go to the part of the service that they judge best, without professional advice.

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