HC Deb 23 January 1990 vol 165 cc728-9
5. Mr. Watson

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

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

I last met representatives of the British Medical Association formally on 18 October 1989 when we had a friendly and constructive discussion about the implementation of our proposals in the White Paper "Working for Patients".

Mr. Watson

Will the Secretary of State draw to the attention of the BMA the fact that in anticipation of changes in GP contracts and changes to the Bill some GPs are already beginning to strike off their lists patients whom they regard as potentially uneconomic so that far from choice for patients being increased, some patients are losing the choice even to remain with their existing GPs? I know that the Secretary of State does not keep such information, but will he now undertake to do so in order that he can monitor any such changes in GPs' lists and the fate of those patients affected?

Mr. Clarke

I personally have seen no evidence whatever that any such practice is taking place. If any GPs were striking off their lists elderly or chronically sick patients, they would be doing so on a mistaken interpretation of the contract. If they study the new contract for GPs and the proposals in the White Paper, they will see that there is no financial or other incentive to any GP to refuse to accept an elderly or chronically sick patient.

Mr. Viggers

Does my right hon. and learned Friend agree that many patients, especially elderly people, have been frightened by comments made by some doctors which have fallen short of the level of objectivity and accuracy that one would expect from the profession? Can my right hon. and learned Friend confirm that no patients will be deprived of the medicines they need and that in particular, the indicative drug budgets are likely to be very helpful in encouraging doctors to prescribe well?

Mr. Clarke

I am sure that my hon. Friend agrees that we welcome the end to such campaigning over recent months. There was certainly no such suggestion at my last meeting with the BMA. It is extremely unfortunate that last summer a great deal of effort was put into concocting inventions about our proposals and then publicising them to patients. I hope that now we can put behind us some of the damage that did to doctor-patient relationships.

Ms. Harman

Will the Secretary of State look into the case of Mrs. Jackson who arrived home from hospital to find on her doormat a letter from the Hillingdon FPC saying that she had been struck off her GP's list because she would require too many expensive night visits? Will the Secretary of State together with the BMA now monitor the growing number of so-called uneconomic patients who, because of the GP contract and the changes in the forthcoming National Health Service and Community Care Bill, are losing the right to stay with their own GPs?

Mr. Clarke

I shall certainly look into that case. I should be extremely grateful if the hon. Lady would pass on to me the evidence that she has to support it. I would strongly disapprove of anybody being struck off on that ground or any other. The only change that the new GPs' contract is making is that doctors who carry out their own night visits, or send a doctor from their own practice, or one who is likely to be known to the patient, will be paid three times as much for those visits as one who uses a deputising service. That encourages a welcome improvement in patient services. If the hon. Lady's allegation turns out to be true, I shall certainly investigate it most closely.