HC Deb 26 January 1993 vol 217 cc856-8
2. Mr. Gerrard

To ask the Secretary of State for Health if she will make a statement on the capital sums required by London FHSAs for upgrading general practitioner facilities to implement Tomlinson report proposals.

The Secretary of State for Health (Mrs. Virginia Bottomley)

The Government are considering ways in which health care in London can be improved, especially primary health care. I shall make a full statement shortly.

Mr. Gerrard

Does the Minister accept that substantial investment is needed to bring GP surgeries up to standard, especially in areas of London such as my constituency, which has the highest proportion of single-practitioner GP practices in the country? Why will not she give the House the estimated cost per surgery? I assume that she must know the figures. Does she not understand that people in London want to know when their primary health care will be improved and what it will cost, and to be assured that the money will not come from cutting other health service facilities?

Mrs. Bottomley

I accept that the people of London want to know what is going to happen and to bring the uncertainty to an end. They rightly want to be confident that changes will be based on improvements in primary health care. Significant further advances in primary health care have been made. Capital investment, for example, has doubled in the past two years, but very much more needs to be done. We are having detailed discussions before making announcements.

Mr. Carrington

Does my right hon. Friend accept that Londoners are keen to see greater investment in primary health care, but that they also need investment in hospitals? Will she join me in welcoming the opening of the Chelsea and Westminster hospital, at a cost of £204 million, which is the most advanced, state-of-the-art hospital in Europe and will provide magnificent health care to west London? Does she agree that that represents a marvellous achievement for London's health service and is a testimony to the investment that the Government are making in health care in London? Will she also—

Hon. Members

No.

Madam, Speaker

Order. This is Question Time, not the time when Members make statements. The hon. Gentleman must have had three bites of the cherry already. I am sure that the Secretary of State is more than capable of answering.

Mrs. Bottomley

I warmly congratulate my hon. Friend on his fluency in advocating the excellence of the new hospital. London will indeed remain a centre of excellence in hospital care, in research and in education. But we must look forward and make changes. The hon. Member for Walthamstow (Mr. Gerrard) is also right that that must be balanced with proper recognition of the role of primary care. These are difficult decisions, but they are decisions which we shall take.

Ms. Primarolo

In reply to my hon. Friend the Member for Walthamstow (Mr. Gerrard), the Secretary of State referred to the improved investment in primary care. She must surely be aware that the Tomlinson report showed that 46 per cent. of GPs are performing below the national average, which is only 7 per cent. She is probably also aware that the Acheson report of 1981 stated that only 15 per cent. of GPs were performing under the national average in London. Since 1981, 5,000 beds have been closed to pay for improved primary care in London. There has been a threefold deterioration in the service. When will the Secretary of State take some action instead of lecturing us and offering platitudes?

Mrs. Bottomley

The hon. Lady clearly fails to understand that significant improvements have been made in London, mainly as a result of the new GP contracts, which the Labour party voted against. The deprivation payments, the targets payments for immunisation and cancer screening have at last led to improvements in inner-city areas, but more needs to be done. I welcome the hon. Lady's appreciation of many of the valuable points that are made in the Tomlinson report. She also referred to the Acheson report. Many of its recommendations have been implemented, the most important being the new GP contract which has set the tone for family doctor services across the country. The Labour party voted against that.