HC Deb 22 March 1994 vol 240 cc123-5
6. Mr. Kevin Hughes

To ask the Secretary of State for Health what were the average savings made by GP fundholding practices in 1992–93; and if she will make a statement.

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

Provisional figures suggest that in 1992–93 fundholders achieved efficiency savings of between 3 and 4 per cent. That means that an extra £30 million is to be re-invested in patient care. It shows what can be achieved when GPs take control of managing resources for their patients.

Mr. Hughes

By being able to cream off national health service funding in that way, are not some GP fundholders giving yet more credence to the fast-track, two-tier health service, while other people are having to wait in long queues for out-patient appointments and are facing hospital closures? Does not the Secretary of State agree that it is time that we got back to a needs-led health service, in which patients come first all the time?

Mrs. Bottomley

I do not accept the hon. Gentleman's comments at all. I am perplexed to hear his remarks because in Doncaster, there is a high standard of care for all patients, whether or not they are with GP fundholders. Almost all out-patients are to be seen in three months by July and no patient will be waiting longer than a year by July, whatever category that patient is in. That is an achievement about which I should have thought the hon. Gentleman would take the opportunity to tell the House. He has fundholders in his constituency, as elsewhere. They are at the leading edge of the reforms and all general practitioners are benefiting from the changes pioneered by the fundholders.

Mr. Congdon

Is my right hon. Friend aware of the significant savings that GP fundholders have made in their drug budgets? Will she consider how such good practice may be extended to all GPs?

Mrs. Bottomley

My hon. Friend is exactly right. GP fundholders are showing a 4 per cent. advantage over the non-fundholders in curbing the increase in their drug budgets. It is an example of the way in which, when GPs are the gatekeepers of the NHS and have direct control over resources, they steward those resources more carefully and can invest in better patient care for others. We want to extend that system to all GPs at the earliest opportunity.

Ms Primarolo

Is the Secretary of State aware of the survey and report in Doctor magazine showing that, in the current year, GP fundholders will accrue £50 million in profit? Is not it obscene that £50 million should be accruing to fundholders when hospitals are turning patients away and cannot treat them because they are running out of money? Does not that finally prove that fundholding is inefficient, expensive, unfair and wasteful? When will the right hon. Lady act for the patients?

Mrs. Bottomley

I am sure that the hon. Lady appreciates by now that the savings achieved through greater efficiency by GP fundholders are ploughed back into patient care. Fundholders show how we can get better value for the inevitably finite resources invested in the national health service. I commend to the hon. Lady not only Doctor magazine, admirable though it is, but a study of the recent King's Fund report on evaluating the NHS reforms, which states that abolishing fundholding would probably lead to a substantial exodus from the NHS of fundholders setting up private insurance based HMOs. The Labour party would have finally broken up the NHS, which would be par for the course in stupidity! I commend those remarks to the hon. Lady.

Mr. Thomason

Will my right hon. Friend confirm that she is aware of, and welcomes, the Bromsgrove project in my constituency, which has been possible because all four fundholding practices in Bromsgrove are fully behind what her Department is doing? Will she commend the scheme and back its aims, and recommend that if it proves successful it should be extended to other parts of the country?

Mrs. Bottomley

The first of April will be a watershed in the establishment of GP fundholding, with about 36 per cent. of the population being covered. The task now, as my hon. Friend has described, is to find out how we can take fundholding forward, extending its benefits to non-fundholding GPs and ensuring that fundholders are able further to influence the way in which resources are allocated. GPs are the advocates on behalf of their patients, and GP fundholding has been one of the most important initiatives of the past five years.