HC Deb 07 June 1989 vol 154 cc224-6
13. Mr. Bill Walker

To ask the Secretary of State for Scotland what representations he has received from general practitioners in Tayside about the Government White Papers on the Health Service.

Mr. Michael Forsyth

About 80 letters have been received from general practitioners in Tayside, direct or through hon. Members, referring to various matters arising from the Government's White Papers "Promoting Better Health" and "Working for Patients".

Mr. Walker

I thank my hon. Friend for that reply. Is he aware that at meetings I had with individual GPs and with representatives of GPs in Tayside it became clear that the GPs had not understood—[Interruption.]—properly and fully just how much control they would have over decisions affecting where they could send their patients—because the payment will follow the patient—and how important that was for the popular community cottage hospitals in the future?

Is he further aware that doctors were horrified when they were made to realise that the lies contained in the leaflet distributed by them on behalf of the BMA were making many pensioners unhappy and concerned because of the fear that in future they would not be able to get their prescriptions and receive treatment, and as a result of that they propose to do something about it?

Mr. Forsyth

There is no justification whatever for patients being frightened or misled about the White Paper proposals. We have had a positive response from GPs in Scotland—[Interruption.] Indeed, the new contract which has been agreed by their negotiators is based very much on the proposals which were put forward in Scotland.

In response to Opposition Members who scoff at the assertion by my hon. Friend the Member for Tayside, North (Mr. Walker) about the degree of interest in the extent of control which GPs can obtain as a result of GP-based budgeting and self-governing hospitals, I can say "yes" to my hon. Friend and tell him that I have received from his constituency representations not only about self-governing hospitals but about GP-based budgeting, with considerable enthusiasm being shown by the persons concerned.

Mr. Foulkes

May I inform the hon. Member for Tayside, North (Mr. Walker), as a psychologist—[Interruption.] He is not; I am. May I inform him that there is absolutely no evidence to show that the general practitioners in Tayside are any less intelligent than the GPs in Ayrshire? All the GPs to whom I have spoken in Ayrshire understand only too well what is meant by the White Paper. They have passed a resolution unanimously condemning it and asking the Government to withdraw it.

If members of the Government, and in particular the Minister, mean anything when they use the word "consultation"—if they are not to be seen as people who are not men of their word—the only honourable action for them to take now is to withdraw the White Paper.

Mr. Forsyth

I am tempted to reply to the hon. Gentleman by saying "physician, heal thyself." I had a meeting with GPs in Ayr on Monday. After an hour's discussion with them I formed the same conclusion as my hon. Friend the Member for Tayside, North (Mr. Walker)—that many of the details concerning our proposals were not understood and had not been communicated to them.

I am happy to tell the House that the objectives of our White Paper—to increase patient choice, to increase the emphasis on preventive medicine and to make the NHS more responsive to the needs and wishes of patients—are objectives which all of those GPs were happy to endorse. The mechanisms, mechanics and best way forward are issues on which GPs should not pass resolutions of condemnation. They should roll up their shirt sleeves and help us to get this right.

Mr. Hind

When my hon. Friend replies to the representations from the GPs in Tayside, will he emphasise that indicative budgets, both practice and drug budgets, mean that no patients need fear lest the resources for their treatment will not be available? Will he ask them to withdraw the leaflet from the BMA, which unnecessarily winds up elderly and sick patients and makes them fear that the necessary resources will not be available?

Mr. Forsyth

I wrote to the British Medical Association in Scotland asking it to withdraw the leaflet from Scotland. I received a reply saying that the leaflet had been produced in London and that it did not take entire responsibility for it. I also pointed out the assertions in that leaflet about our proposals, which are frankly just untruths. The response from the BMA in Scotland did not seek to defend the assertions which are made in that leaflet. I believe that events have moved on and that there is a coming together to get the proposals right, certainly in regard to the contract.

I agree with my hon. Friend that it is completely irresponsible to say to any patient that he will be denied treatment or drugs as a result of the proposals. Thai is not true. No general practitioner, whether a budget-handling GP or a GP subject to indicative budgets, will find that he does not have the resources to treat the patients. Opposition Members who say such things are causing needless anxiety to patients.

Mr. Robert Hughes

The hon. Member for Tayside, North (Mr. Walker) has made astonishing charges of ignorance against doctors in Tayside. Is he saying, however, that it is because the doctors are too thick to understand the White Paper or that the Minister is too thick to explain it properly?

Mr. Forsyth

I am saying that the type of intellectual approach that the hon. Gentleman has shown in his question is not one that I would expect from doctors. I would expect doctors to study the proposals carefully, to form a considered judgment, to identify the particular aspects causing them concern and to discuss with the Government the best way forward. That has not always been the case, but I accept what I think is implicit in the hon. Gentleman's question, which is that the vast majority of doctors will rightly see the way forward as being one which looks to their patients' interests. The White Paper is based on putting the patient first and ensuring that the Health Service delivers the best possible quality of care with the substantial additional resources that are available within the NHS.