HC Deb 08 December 1992 vol 215 cc681-3
6. Mr. Booth

To ask the Secretary of State for Health what plans she has to meet representatives of the National Association of Fundholding Practices to review their progress.

Mrs. Bottomley

I met representatives of the National Association of Fundholding Practices on 18 November when we discussed the significant benefits that fund holding is bringing to patients. I am pleased to be able to tell my hon. Friend that I shall also address the second annual conference of the National Association of Fundholding Practices tomorrow.

Mr. Booth

Will my right hon. Friend welcome the success of the fund-holding practices and in particular the way in which they have played their part in reducing waiting lists throughout the nation? Will she welcome the way in which we have brought down waiting lists since 1979?

Mrs. Bottomley

I certainly warmly commend the fund-holding practices and the national health service generally for the progress that they have made in reducing waiting lists. The Labour party said that we would never meet the targets for waiting lists, just as it said that we would never meet the targets on immunisation or cancer screening. We have met all those targets and, indeed, beaten them. But the contribution of fund-holding practices goes much wider than tackling waiting lists; it concerns the quality of care, the integration of primary and secondary care and the dramatic progress in bringing down the cost of drugs.

Mr. Burden

Given what the Secretary of State has said, what advice would she give to my constituent, Mr. Kitching, whose general practitioner referred him for an appointment because he might require surgery to his knee, in which he had arthritis? He was told in January this year that the waiting list for an appointment was about 91 weeks. Last month, he received a further letter telling him that he might have to wait another 13 weeks. Would the Secretary of State say to Mr. Kitching that that is an appropriate or reasonable time to wait? If she would, why is she also considering shutting the royal orthopaedic hospital in Birmingham, which could provide Mr. Kitching with the treatment that he needs?

Mrs. Bottomley

All are agreed that there is more for the national health service to do. All are agreed, I hope, that remarkable progress has been made in reducing long waiting times. We hope to set an out-patient target under the patients charter initiative. However, it is not by avoiding difficult decisions that further progress for patients is made. It is certainly the case that GP fund holders have pioneered innovative treatments and care of their patients which others have been able to follow.

Mr. Rathbone

Can my right hon. Friend give us an assurance on the way in which fund holders have improved the services that they offer to patients—rather than having to send them to hospital, for example—in analyses for diabetes or cholesterol?

Mrs. Bottomley

Indeed, there are numerous practical examples of the ways in which fund holders have developed new services, either by inviting consultants to undertake out-patient work at their practices—by way of a treat and teach model—by pioneering different ways to deal with diagnostic assessments, or by the organisation of a contract with the local hospital, which other general practitioners have followed. The point is that GP fund holders have been able to push forward the frontiers and to demonstrate new models of practice, which can then be spread widely within the NHS.

Ms. Primarolo

When the Secretary of State speaks to the National Association of Fundholding Practices tomorrow will she make it clear that the House is appalled at the massive profits that GP fund holders are making out of the national health service? We consider it scandalous that practices can make £190,000 or £280,000 in profit from fund holding when cash-starved hospitals are freezing waiting lists. Will she ensure that that money is returned in full to the district health authorities, so that it can be spent on patient care, especially the care of those on long waiting lists?

Mrs. Bottomley

Yes, we see the two-facedness of the Opposition. They profess to believe in primary care, but when we find a way to mobilise it so that GPs can act on behalf of their patients, they say that they dislike it. I suspect that at the next election the Leader of the Opposition will say that fund holding is another policy with which he agreed, but that he did not think that he could face up to telling his party that he supported it. Fund holders are saving 4 per cent. in their fund-holding work. The point is that that money can be invested in the practice, to make further improvements in primary care.

Mr. Dunn

Is the Secretary of State aware that two practices in my constituency are now fund holding—at Longfield and at Dartford East—and that they are both working extremely well, to the benefit of patient care? Is she also aware that my Labour opponent at the last election is a general practitioner in a practice in Bexleyheath, which is in the fourth wave of applications for fund-holding status?

Mrs. Bottomley

I am delighted to hear that information from my hon. Friend. I very much hope that in spite of the mischievous and often wilfully misleading comments of the Opposition, sensible GPs who put their patients' interests first will see the advantages of fund holding for themselves and for the progress that it can encourage throughout the NHS.