Practice Nurses (Hansard, 22 February 1994)

§ 6. Mr. Duncan
To ask the Secretary of State for Health how many practice nurses are employed by general practitioners; and what was the number prior to the introduction of the general practitioner contract.

§ Mr. Bowis
Many practice nurses work part time; translated into whole-time equivalents, the number more than doubled from 4,632 in 1989 to 9,680 last year.

§ Mr. Duncan
I think that hon. Members on both sides of the House would welcome any improvement in primary health care that results from an increase in the number of practice nurses—[Interruption.] Has my hon. Friend—[Interruption.]

§ Madam Speaker
Order, Mr. Campbell-Savours. Mr. Duncan.

§ Mr. Campbell-Savours
I was just explaining.

§ Mr. Duncan
Has my hon. Friend had an opportunity to read a recent Labour party policy document, which claims that the Labour party wants an improvement in primary health care? How does he reconcile that with the Labour party's wish to abolish fundholding, when fundholding practices are exactly the practices in which the improvement in primary care is taking place?

§ Mr. Bowis
My hon. Friend is right on both counts. He is right to point out the genuine support that practice nurses are able to give our GPs in helping them to meet immunisation targets, to carry out minor surgery, to take part in our asthma and diabetes programmes, and so on.
As for the second part of my hon. Friend's question, I shall not be held to account for Labour's policy. Labour will be held to account for its policy and it will have to account to the taxpayer for the cost of its policy. As my hon. Friend rightly says, Labour would destroy what is good and send us a bill for £6 billion for the privilege. That is 4p on income tax for starters.

§ Mr. Enright
Will the Minister stop indulging in petty party politics, which ill suits him, and answer the question? Is it not nonsense that in the present situation a fundholding practice in Yorkshire can go to down to Dorset to hire a practice nurse, use the same nurse and cut her pay afterwards?

§ Mr. Bowis
I am glad to know that that is not a party political point. I remind the hon. Gentleman that when the Labour party was in office in 1979—[Interruption.] The hon. Gentleman does not want the answer to the question. At that time, we had 888 practice nurses. We now have 9,680 practice nurses. The hon. Gentleman is a schoolmaster; even in the classics department, that would work out as an increase of 900 per cent. That is quality, and that is progress for fundholders and all GPs.

§ Mr. Hayes
My hon. Friend said a moment ago that the Labour party would be accountable for its policies. In the next few moments, will he try to find out what those policies are, apart from the abolition—

§ Madam Speaker
Order. If the hon. Gentleman is going to ask a question about Government policies I will listen to him. As he knows, the Government are not responsible for the Opposition.

§ Mr. Hayes
I was going on to congratulate my hon. Friend on the 900 per cent. increase in practice nurses since 1979 and the effect that the abolition of GP funding would have on that.

§ Mr. Bowis
My hon. Friend is right. If it were Government policy to seek to understand Opposition policy, that is the one policy on which we would have to declare a failure.

§ Ms. Primarolo
Is the Minister aware, before he congratulates himself, that the number of managers in general practice has increased by 34 per cent. since the introduction of the 1990 GP contract? Is he also aware of the low morale and frustration among GPs as a result of the increasing demands on their time for bureaucratic, time-wasting work? Today's survey—I am sure he is aware of its publication—shows a 9.4 per cent. increase in GP fundholders' work. When will the Government act to review immediately the GP contract and fundholders, stop wasting patients' money on bureaucracy and spend it on the patient instead, which is what we intend to do?

§ Mr. Bowis
If 90 per cent. of GPs are now involved in the chronic disease management programme, if 76 per cent. are involved in minor surgery and if 86 per cent. are reaching their higher child immunisation targets, I think that we can say that GP targets are doing very nicely, thank you, without the hon. Lady's criticism. If she went into the average GP's surgery, she would meet many people who support GPs and who would resent her attack on that support. For her to dismiss all GPs as "managers", using that as a derogatory term, is ludicrous. She should remember that, in supporting GPs, we are supporting primary care and that we are doing so to the tune of a £504 million a year increase on the £206 million that we spent four years ago. Again, that is progress and, again, the hon. Lady does not like it.

§ Mr. Oppenheim
How does that information square with what was being said when the GP contract was introduced? Did not the doctors' trade union—the British Medical Association—and the Opposition try to frighten the sick and vulnerable by telling them that the GP contract would increase doctors' lists and reduce the number of practice nurses? As that has clearly not happened, how seriously can we take any pronouncements by the Opposition about the NHS when they are prepared to try to frighten the sick and vulnerable so unnecessarily?

§ Mr. Bowis
My hon. Friend is right. Doctors had their concerns when the contract came into force, but we understood their concerns and listened to, and took account of, them. Doctors are now pleased, I think, that the contract is in place. It is helping them to see more patients every day of their working lives. The doctors have moved on, but the Labour party has not.