HC Deb 08 December 1992 vol 215 cc685-6
9. Mr. Hendry

To ask the Secretary of State for Health if she will make a statement on progress towards adoption by general practitioners of fund-holding status.

10. Mr. Gill

To ask the Secretary of State for Health what assessment has been made of how general practitioners' interest in the fund-holding initiative has changed since the scheme began.

Dr. Mawhinney

I am pleased to report growing interest and support for fund holding amongst GPs, who are realising the benefits that it brings patients. By April 1993, more than 1,000 practices will have joined the fund-holding schemes, covering one in four of the population.

Mr. Hendry

I am grateful to my hon. Friend for that reply. Is he aware that in High Peak every GP practice eligible for fund-holding status has achieved it or applied for it? Is not that a clear demonstration that even if the Opposition fail to realise the benefits of fund-holding status, doctors who are most in touch with their patients' needs clearly do?

Dr. Mawhinney

I am sure that my hon. Friend is right. It shows that GPs have been listening to their patients and probably also to their Member of Parliament.

Mr. Gill

Notwithstanding the massive amounts of additional money which the Government continue to pump into the national health service, does my hon. Friend agree that the efficiency savings made by GP fund holders are extremely valuable because they free resources so that more patients may be treated?

Dr. Mawhinney

Of course, my hon. Friend is absolutely right. We are concerned that more patients should receive high-quality treatment from the record amount of resources made available. It is a matter of regret that others do not take the same view.

Mr. Cryer

Will the Minister assure the House that, in cutting down waiting lists, GP fund holders will not be able to get privileges for their patients by paying extra to NHS trusts and gaining access to hospitals? If he will not give that assurance, he stands convicted of establishing a two-tier system in the NHS, which is supposed to be a service open to all, free at the point of use. One tier will be for GP fund holders' patients and another will be for the rest.

Dr. Mawhinney

The hon. Gentleman knows, but will not accept, that clear rules have already been agreed with representatives of the medical profession. Those rules preclude a contract being set if it will disadvantage other patients. The hon. Gentleman has been told that before and he must simply accept it.

Mr. Bryan Davies

If and when GP fund holders overspend, who pays?

Dr. Mawhinney

The hon. Gentleman asked me a similar question last time. He will recall that I told him that there was some imprecision in the early stages of setting GP fund holders' budgets. I told him that, in a few cases, GP fund holders had to go back to the region to have their base budgets adjusted in the light of experience. The reverse of that coin is also true. We are discussing with some GP fund holders the return of some of the money which they received from the similar imprecise setting of their budgets. He will be pleased to know that we are doing that with the full support of the National Association of Fundholding Practices.