General Practitioners (Hansard, 24 May 1994)

§ 8. Mr. Mandelson
To ask the Secretary of State for Health how much, on average, general practitioner fundholders spend on purchasing health care in the private sector.

§ Mrs. Virginia Bottomley
General practitioner fundholders can purchase health care from whichever hospital best suits the needs of their patients. In 1992–93, fundholders spent just over 1.5 per cent. of their budget with non-NHS organisations. In doing so, they have improved waiting times, convenience and standards of service for patients.

§ Mr. Mandelson
Is not it a scandal that the draining of public funds from the national health service to private medicine has doubled since 1991 and that the national health service has been denied much-needed cash as a result of that policy? Is not it also a classic illustration of the two-tier health system that the Government are creating? Is not it now time for Ministers to impose a strict limit on that diversion of public funds to private health care?

§ Mrs. Bottomley
The hon. Gentleman may think that 1.5 per cent. is a substantial sum, but I have to disagree. As ever, he is scaremongering and speaks as the political apparatchik that he is. His obsession with the ownership of the means of production shows him to be the clause 4 socialist so typical of the Labour party. He failed to tell us that no patient in his constituency waits more than 12 months for treatment and that a maternity unit there recently received a quality award and has won "Heartbeat" awards. There have been a great many developments, in addition to the further initiatives pioneered by fundholders, from which all patients benefit.

§ Mr. Forman
Did I hear my right hon. Friend say 1.5 per cent? Does not that represent exceptionally good value for money for patients and for the health service? What proportion of general practitioners are now in fundholding practices?

§ Mrs. Bottomley
Yes, my hon. Friend is exactly right. A modest amount is now spent in the independent sector, but we are motivated by patients, not by the means of providing care. We want to look for ever-better value for money that provides quality and quantity of patient care. Just over 35 per cent. of the population benefits from GP fundholding practices, but we want to extend the benefits of fundholding as far and wide as we possibly can. Fundholding has changed the balance of power in the NHS and changed it in favour of the patient.

§ Ms Primarolo
Is the Secretary of State aware that £268 million—a not insubstantial amount—was spent in private hospitals in 1992–93 Is she also further aware that one fundholding practice in Colchester spent 90 per cent. of its funds at a local private hospital? Does she agree that it is unacceptable that taxpayers' money should be used to subsidise private hospitals and private profit when national health service hospitals are running out of money and turning patients away? When will she protect the NHS against private medicine—a move which would benefit patients?

§ Mrs. Bottomley
Now you see them in their true colours, Madam Speaker—a party dominated by the public sector unions. Patients will not trust the Labour party until its spokesmen renounce their National Union of Public Employees sponsorship. The Labour party is dominated by the interests of the public sector unions, not the interests of patients. I recall Barbara Castle's comments on her decision to abolish pay beds. She said that it was an essential political sweetener for the unions. A recent document again revealed the vendetta against the private sector and the private bed. Our prejudice is in favour of patients.

§ Mr. Congdon
Does my right hon. Friend agree that fundholders have introduced innovation in their approaches to patient care, which have demonstrated the benefits of devolved budgets? Is she aware that GP fundholders not only spend under their drug budgets but spend less than non-fundholders?

§ Mrs. Bottomley
My hon. Friend identifies precisely why GP fundholding has been so successful. GP fundholders prescribe around 4 per cent. more cost effectively than non-fundholders. That is one of many examples of the way in which GP fundholders have used the resources at their disposal cautiously and effectively, acting as good stewards so that they can extend the quality and quantity of care. GP fundholders are not given more money, but do more with the money that they are given. We want to level up a top-tier service.