HC Deb 05 February 1991 vol 185 cc149-50
6. Mr. Hind

To ask the Secretary of State for Health how many general practitioners have opted to become budget holders; and if he will make a statement.

Mr. Waldegrave

I am pleased to be able to tell my hon. Friend that there are currently around 300 practices undertaking the preparatory work necessary to become fundholders from 1 April.

Mr. Hind

Does my right hon. Friend agree that the essence of the internal market in the NHS is choice and that if it is to succeed, more general practitioners must be encouraged to take up budget holding and more hospitals, such as Wrightington on the edge of my constituency, must be encouraged to become national health trusts?

Mr. Waldegrave

The benefits of both systems are becoming increasingly understood. Both systems are voluntary, but tremendous benefits are available to patients from the GP fund-holding scheme—a matter which I hope that Opposition Members will consider in due course, because it would be paradoxical if that aspect, which is aimed at giving help to patients and those most directly representative of them, should run into opposition from the Labour party.

Mr. Bradley

Is the Secretary of State aware that the denial of interleukin-2 to a patient at Christie hospital shows the problem of fixed budgets? In a written answer to me the Department of Health said that that drug could be used on a named patient. The drug and therapeutics committee said that the drug was not being prescribed not because it did not agree with it in principle but because this could not be achieved within existing funding. That drug has not been allowed to Mrs. Kendrick and 50 others because the budget is overspent. Will the Secretary of State please review the position and ensure that life-saving drugs are available to all patients if they are about to die?

Mr. Speaker

Order. This is an important matter, but the question was too long.

Mr. Waldegrave

My hon. Friend the Under-Secretary of State has dealt with the matter once. I repeat that the truth of the matter is that the drug and therapeutics committee of that hospital took an entirely sensible view that against the background of doubts about the drug—[Interruption.] The hon. Gentleman will find that at the time the meeting took place the committee believed that the drug had a product licence whereas in fact it did not. Other, more expensive drugs are still being prescribed in the hospital.

One doctor breaking ranks with his colleagues like that and taking an individual case is exactly the wrong way to make decisions about such matters and puts patients in a difficult position. We must stand on the clinical decisions of the committees in the hospitals. They have always had difficult decisions to make about alternative treatments. I am sure that the doctors in that hospital took the right decision, which was not to spend a large sum of money on a drug of doubtful efficacy.

Mr. Nicholas Winterton

My right hon. Friend will be aware that the Select Committee on Health will be carefully monitoring the effects of the NHS reforms. If he and his colleagues wish to remain closely in touch with what is happening at the grass roots, will he accept an invitation from Cumberland house, the largest general practice in my constituency, which has opted for budget-holding status, to discuss what it sees as the advantages and some of the expected problems of budget holding?

Mr. Waldegrave

I visited my hon. Friend's constituency not very long ago, and very pleasant it was, too. I will try to fit another into my programme. I also visited two proposed budget-holding practices in East Anglia and south London, and I was very impressed by the enthusiasm shown at both. They will rapidly offer patients significant benefits.