HC Deb 26 October 1993 vol 230 cc684-6
10. Mr. Heald

To ask the Secretary of State for Health how many general practitioner practices are now participating in the fund-holding initiative; and what was the figure in April 1991.

Mrs. Virginia Bottomley

The number of fund-holding practices is more than double what it was in 1991. It now includes 6,000 family doctors in 1,235 practices. The growing success of the scheme is shown by the fact that we expect a further 800 practices to join from next April.

Mr. Heald

Does my right hon. Friend agree that the rapid expansion that she has just announced, together with the fact that north Hertfordshire has more GP fund holders than any other district in the North West Thames region, shows the popularity of the scheme with ordinary family doctors? Does she agree that the next battle is to persuade the remaining doctors to join the scheme and to enable them to do so?

Mrs. Bottomley

I entirely agree with my hon. Friend. It looks as though, from next April, 99 per cent. of patients in his area will have a GP fund holder. It is a voluntary scheme for consenting adults. We believe that more GPs should see the advantages of fund holding. The best way in which they can do that is for them to talk to someone who has already taken forward the scheme, which now provides care for 12 million patients.

Mr. Flynn

Is the right hon. Lady aware that she is correct to say that we do not have a two-tier health service? In fact, we have a three-tier health service, with private patients jumping the queue and getting their treatment within days, fund-holding GPs' patients getting their treatment within months and non-fund-holding GPs' patients getting their treatment only within years. Is she proud to have increased privilege in the health service?

Mrs. Bottomley

Once again, the hon. Gentleman shows a bitter, blinkered and rather vindictive approach to the delivery of health care. I suggest that he talks to David Colin-Thome, who was previously a Labour candiate and who said that GP fund holding was the most energising thing to have happened to general practice in his 20 years as a doctor. We must not only set the national standards that the Labour party said we would never meet—we have not only met them, but beaten them—but find ways in which to encourage the rest to do as well as the best. The scheme is voluntary and we want more fund holders to come forward.

Mr. Hayes

Does my right hon. Friend agree that GP fund holding is very popular with patients, because it improves patient services, and also with GPs, who are voting with their feet? Can my right hon. Friend offer any psychoanalysis to explain why the Labour party is intent on abolishing this popular reform?

Mrs. Bottomley

I am afraid that the Labour party, which constantly looks backwards rather than forwards, cannot bear to devolve power: it all has to be command and control. The whole point about GP fund holding is that it empowers the GP. It is the GP who is the agent of the patient and when he has control over the budget, which would otherwise have been spent for him, he makes shrewd and wise decisions which are sensitive to patients' needs. That is the distinction between our party and the Labour party. The Labour party wants to tell people what to do; we want to empower them.