National Health Services (Amendment) (Hansard, 15 June 1993)

§ Mr. Mike Hall (Warrington, South)

I beg to move, That leave be given to bring in a Bill to make further provision as to the functions of Family Health Services Authorities in relation to the rights of general practitioners' patients; and to amend section 20 of and Schedule 7 to the National Health Service Act 1977 to ensure that such patients are consulted by Family Health Services Authorities when substantial variations are proposed to their medical services. The need for the Bill arose because of recent events that took place on the Windmill Hill estate in the Runcorn part of my constituency. Those events demonstrate the ineffectiveness of both the Department of Health and the patients charter to protect the interests of the general public.

On 29 April 1993, the doctor's surgery that serves the Windmill Hill estate district of my constituency was closed, and 703 patients of Dr. O'Connor were given only five days' notice of the decision. They were confronted by the news that they had only five days to find another general practitioner.

A number of my constituents in that district are elderly, a number of them are disabled and some of them are both. The district contains many families with young children who live on the estate. The decision to close the local doctor's surgery meant that they would now have to travel even further to the nearest general practitioner.

It will be a difficult journey for a number of my constituents, for a number of reasons. First, there is an inadequate bus service to the next doctor's surgery, and many of my constituents are not car owners, which means that they will have to walk the two miles to the doctor's surgery through open park land, which, when the climate is bad, will mean a difficult journey. It will mean that, every time that those constituents need to see a general practitioner, they will have to make the journey on foot to and from their doctor's surgery.

The provision of locally based general practitioners and their surgeries is a fundamental and essential part of proper care in the community. Indeed, it is probably the starting point of care in the community, but my constituents have had the facilities at that starting point removed. My constituents' reaction to the decision was one of anger that they had not even been consulted by the family health services authority. They were anxious that the provision of services to them was to be removed, and they were concerned that the level of health service provision in that part of Runcorn would be diminished.

It is the role of the family health services authority to consult on such issues, but it did not consult my constituents. It did not even give them warning that the decision was on the way. It simply sent them a curt circular letter telling them to find themselves another general practitioner within five days. It gave a list of the surgeries which my constituents could use. My constituents were not asked whether or why—they were not consulted, but were told what they would have to do. The decision had an immediate impact on the services of the local hospital.

A number of my constituents said that they were unable to find a doctor's surgery within five days and that if something was wrong with them they would go to Halton general hospital for their medical needs. I was confronted 738 by my constituents on the day that the decision was taken and I promised them that I would raise the matter in the House of Commons in any way I could.

I raised the issue during business questions, and asked for a statement, but was told that, as I had informed the Department of Health that day, I would be receiving a letter. I tried unsuccessfully to catch your eye, Madam Speaker, at Health questions, but was unable to do so. I now have the opportunity of the ten-minute Bill procedure to raise the issue on the Floor of the House.

When I realised that my constituents had been presented with a fait accompli, I was not sure what to do, as I had already raised the issue with the Department of Health. I turned to that champion of citizens' rights, the citizens charter, published in July 1991. Page 5 states: The public sector should provide choice wherever practicable. The people affected by services should be consulted. Their views about the services they use should be sought regularly and systematically to inform decisions about what services should be provided". Page 10 of the document states: Health Authorities must seek local citizens' views on their services. I also looked at the patients charter, as I thought that it might provide back-up and further instructions from the Government. In the foreword to the patients charter, the then Secretary of State for Health wrote: The Government is also firmly committed to improving the Service—to creating a better National Health Service. This means a Service that: —always puts the patient first, providing services that meet clearly defined national and local standards, in ways that are responsive to people's views and needs. I was encouraged by those words, which seemed to give me hope that the views of my constituents on the Windmill Hill estate, who had not then been consulted about the removal of their medical services, would be entitled to have their voices heard.

The Government's commitment in the citizens charter and the patients charter led me to contact the Department of Health to seek its intervention, even at such a late stage, to ensure that my constituents were provided with the adequate medical facilities that they wanted in their locality. It was their view that the surgery should stay open, and that view was in line with the views expressed in the citizens charter and with the supposed rights contained therein.

Unfortunately, I need to present the Bill because the response by the Department of Health was less than adequate. I was advised in writing by the Secretary of State for Health that the legal position on matters of this kind is that the Cheshire family health services authority should consult the Halton community health council about the proposed closure of the doctor's surgery on Windmill hill.

The Minister further advised me that the decision about whether to replace the outgoing doctor rested with the medical practices committee, which is an independent public body. The Minister stated that that committee bases its decisions on reports from the family health services authority, following its consultation with the community health council. The letter stated: The decision of whether to dispense or advertise a vacancy is a matter entirely for the Medical Practices Committee and is not subject to Ministerial intervention. The Minister said that the Cheshire family health services authority had been consulted about the closure of the doctor's surgery on Windmill hill, and that the legal procedures had been followed. That means that the hopes 739 and aspirations contained in the citizens charter, which were said to be at the heart of Government policy in the 1990s, have not materialised, and that the views of my constituents have been totally ignored.

In terms of the National Health Service Act 1977, the promises in the citizens charter and the patients charter to consult people affected by services counts for nothing. Even if the Government wanted to act in this case, they would be prevented from doing so by current legislation. If that legislation remains unamended, the citizens charter and the patients charter are merely expensive paper tigers. They will remain a political gesture which, when put to the test, will be shown to have no teeth and no means of effecting the change that they desire.

That is another example of the Government failing to deliver their promises to the people and of people being misled into believing that the citizens charter is something that it is not.

The matter that I raise is not an isolated incident, because doctors' surgeries are being closed throughout constituencies. My hon. Friend the Member for Walthamstow (Mr. Gerrard) raised the problem 12 months ago in the House. He was told the legal position, which means that the citizens charter counts for nothing in such cases.

In the light of such events, the 1977 Act needs to be changed. My constituents in Windmill hill deserve to have their views heard, and they are entitled to the minimum consultation about their family needs for health service provision in Runcorn.