GP Fund Holders (Hansard, 4 May 1993)

§ 7. Mr. Roger Evans
To ask the Secretary of State for Health what assessment has been made of the interest of family doctors in the general practitioner fund-holding initiative; and how this has changed since April 1991.

§ Dr. Mawhinney
A total of 6,000 general practitioners in 1,200 practices are now fund holders. The number of practices in the scheme is now four times as many as in April 1991 and one in four of the population is benefiting from having a fund-holding GP.

§ Mr. Evans
Does my hon. Friend agree that this is a further piece of good news and that the extension of GP fund-holding, promised in the Conservative election manifesto, is one of the best ways of improving patient care and making the health service more responsive to people's needs?

§ Dr. Mawhinney
My hon. Friend is absolutely right. That causes unhappiness to the Labour party's ideologues —[Interruption.]

§ Madam Speaker
Order. I have heard enough from the hon. Member for Rotherham (Mr. Boyce).

§ Dr. Mawhinney
However, it is of great benefit and encouragement to patients. I can tell my hon. Friend that we are looking for ways to extend GP fund holding even more widely, particularly for those practices which by themselves cannot meet the 7,000 practice list requirement.

§ Ms Lynne
Has the Minister looked into the possibility of setting up locality fund-holding practices, which will help us to get away fromt the two-tier system where fund holders' patients often jump the queue?

§ Dr. Mawhinney
That is nonsense. As I made clear in Chester the other day, the hon. Lady is going to have to come to terms with the fact that from now on we have shared purchasing in the health service. If the reforms are about providing the most patient-sensitive treatment and care possible, GPs are in a maximal position to determine what is good for their patients. Their role in purchasing is central to the reformed NHS and not only will we not back away from it, as the hon. Lady wants, but we will seek to advance it.

§ Mr. Sims
Is not one of the most positive aspects of GP fund holding the arrangement whereby consultants can attend at GPs' surgeries, which must be for the benefit of patients? Is my hon. Friend aware that there is some concern among consultants in dermatology, whose numbers are small and who are worried that they may spend too much time travelling, which is not the best use of an important but limited resource?

§ Dr. Mawhinney
My hon. Friend is absolutely right. Recent surveys have shown that 70 per cent. of fund holders report reductions in waiting times, more than 60 per cent. report improved services for follow-up appointments and over 50 per cent. report increased 10 consultant services in their surgeries. I visited a fund-holding surgery on Saturday and was able to see physiotherapy being delivered to a patient, which was clearly to the benefit of the patient. I note the other point that my hon. Friend has mentioned.

§ Mr. Blunkett
Will the Minister confirm that he has direct responsibility for the implementation of the Government's proposals for health care in London and that on 16 February the Secretary of State, in her statement to the House and in public pronouncements, gave the impression to the world that new money was to be invested in primary health care and GP practices in London? Will he now confirm that that was grossly misleading—that there is to he no new money and that the money that is to be applied is being taken from other vital health care investment, in London and the rest of the English regions?

§ Mr. Mans
Nonsense.

§ Dr. Mawhinney
I think that is probably as good a response to the hon. Gentleman's question as I can think of. The hon. Gentleman knows—although he may not understand—that we have made a real increase in the NHS budget this year. That real increase has been distributed down the normal channels through which money flows from the centre to health care delivery, and it is that real increase which is helping to fund the resources in London. If it were not for this Government. the extra resources would not be made available to improve primary and community health care services in London: that is certainly the tenor of Labour party policy. I am sure that the people of London are very pleased that the Labour party is in opposition and that we are in government.

§ 8. Sir Fergus Montgomery
To ask the Secretary of State for Health how many general practitioner fund-holding practices are in operation in the north-west region; and if she will make a statement.

§ The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville)
Three hundred and twenty-nine general practitioners in 83 practices are now fund holders in the north-west. That means that nearly one in five of all those living in the north-west now benefits from being registered with a fund-holding practice.

§ Sir Fergus Montgomery
Does my hon. Friend agree that there must be considerable satisfaction about the increase in the number of fund holders in the north-west region? For the benefit of the whingers on the Opposition Benches, can my hon. Friend list some of the benefits that patients in the north-west will get from fund holding?

§ Mr. Sackville
I am glad to do so. They will get greater flexibility and an entirely new attitude from general practitioners to the management of their practices. Fund holding will transfer much of the power from hospitals to general practitioners and their patients. May I say, as a fellow north-west MP, that I am sorry that the figure is not greater than one in five of all those who live in the north-west. That is attributable not just to the fact that there are many single-handed and small practices but to the political nonsense that is talked by the Labour party, which represents GP fund holding as being everything that it is not. It is a further example of how the Labour party does not give a fig about patients, only about scoring its own miserable political points.

§ Mr. Bryan Davies
How will GP fund holders and, even more so, those doctors who stay fully loyal to the NHS provide an adequate service for their patients if trusts such as the Royal Oldham trust place increasing emphasis in their business plans on private practice?

§ Mr. Sackville
The suggestion that fund-holding GPs are disloyal to the NHS is outrageous. They are some of the finest GP practices in the country and will be joined by many more, including many single-handed and small practices which are taking advantage of agency arrangements. As for the hon. Gentleman's question about trusts placing increasing emphasis on private practice, surveys show that referral patterns by GP fund holders have remained the same as those of non-fund holders. They have referred fewer rather than more patients to private practice.