§ 6. Mr. Barry Field
To ask the Secretary of State for Health how many practices have now expressed an interest in joining the general practitioners' fund-holding scheme; and how many he estimates will meet the eligibility criteria and be ready for fund holding in April 1991.
§ 14. Mr. Jacques Arnold
To ask the Secretary of State for Health if he will make a statement on progress being made with applications for practice budgets for general practitioners.
§ Mr. Kenneth Clarke
Around 350 practices are preparing for fund-holding status from 1 April 1991, and I have been much impressed by the quality and commitment to the scheme of the practices concerned.
§ Mr. Field
Does my right hon. and learned Friend agree that, while a tiny minority of doctors continue to dispense their own brand of politics, the vast majority are playing an increasingly active part in the delivery of better health care throughout the country? Is it true that on the Isle of Wight a high percentage of doctors have applied to become fund holders?
§ Mr. Clarke
I am glad to say that on the Isle of Wight three practices have been attracted by the idea of having much more control of how NHS money is spent on the isle. Those three practices cover about 30,000 of the residents, which is about one quarter of the population, so there is a particularly high level of interest on the isle. I also agree with my hon. Friend that the experience of fund holding and of the contract is proving very beneficial. Contrary to all the inventions of last year, the amount of time spent with patients is increasing, the amount of minor surgery is increasing, the amount of time spent on health promotion is increasing and the number of practices carrying out child surveillance is increasing. The number of staff and nurses employed by the practices has increased and they are all earning more money. No doubt the fund-holding practices in the isle intend to add to those achievements if they proceed with their applications.
§ Mr. Arnold
Is not the approach that we should follow in respect of GPs' practice budgets one of slowly, slowly catchee monkey? Surely the objective is that we should get the finances to where the patients are and give the clout to general practitioners' practices. Would my right hon. and learned Friend care to contrast that with the full-blooded enthusiasm of Opposition Members to continue with a vast centralised bureaucracy?
§ Mr. Clarke
The pace at which we proceed with fund holding is being determined by the rate at which GPs come forward to volunteer for the scheme. We have 350 practices still actively preparing for next year and many more practices are interested in coming along the year after that. They include some of the people who represented doctors in last year's rows about the scheme and the British Medical Association has now set up a separate group to represent those fund holders, which shows that we are winning converts in quite a lot of places.
I agree with my hon. Friend that the interest of the profession in new developments and what they have achieved from the contract is in stark contrast with the negative positions that have been taken by the Opposition in their sole desire to turn the clock back, if they ever get the chance, to the old bureaucratic and less effective national health service.