HC Deb 14 March 1995 vol 256 cc678-9
4. Mr. Milburn

To ask the Secretary of State for Health if she will make a statement about GP fundholders' savings.

Mr. Malone

Fundholders have achieved efficiency savings of nearly £110 million over the first three years of the scheme. That is about 3.5 to 4 per cent. of budgets set. That money is being reinvested in health services for the benefit of patients. In the hon. Gentleman's constituency, for example, it has been reinvested in physiotherapy services, the purchase of electro-cardiogram equipment machines, more space for doctors to practise and additional nursing cover. I am sure that he will welcome all that.

Mr. Milburn

Why should a minority of family doctors be allowed to sit on what amounts to a huge public subsidy when more than 1 million people are waiting for hospital treatment? What action is the Minister prepared to take to ensure that public resources are made available now for all members of the public, or is he content merely to see the further development of a two-tier NHS?

Mr. Malone

The hon. Gentleman's expertise in these matters seems to extend no further than Essex, where he finds woks for sale in GP fundholders' premises. I am glad that he has treated the House to something slightly more serious than that. As he knows, those savings are spent on a rolling basis. Plans are not only agreed with the regional health authority but audited on an on-going basis. The money is spent on a year-on-year basis on patient care. I should have thought that, because much of that has happened in his constituency, he might have welcomed it.

Mrs. Roe

Does my hon. Friend agree that the ability to make savings that can then be spent on more and better patient care is one of the main benefits that GP fundholding has been shown to have? Does he further agree that one of the places where that message has been heard loudest and clearest is the region represented by the right hon. Member for Derby, South (Mrs. Beckett), where nearly three quarters of the population have a GP fundholder—twice the national average?

Mr. Malone

My hon. Friend is quite right. I had the pleasure of visiting the regional health authority that covers that area. It explained how enthusiastic GP fundholders in the right hon. Lady's constituency were in taking up the challenge that the policy offers, and in bringing benefits to their patients. They will understand that it is a policy that, at least until yesterday, we understood that the Opposition were going to abolish.

Mr. Alex Carlile

Does the Minister agree that any benefits available to the patients of GP fundholders should be at least equally available to patients of non-fundholders who join joint commissioning arrangements, such as those that exist in Nottingham? Will he commend joint commissioning arrangements? If any savings are achieved from fundholding, will he consider applying them to the nearly 900,000 people who have been struck off dentists' NHS lists since the previous general election?

Mr. Malone

The hon. and learned Gentleman raises an interesting point about people who will not join GP fundholding practices, but who provide the benefits by other means. Of course, GP fundholding is voluntary. That is the preferred way of moving forward in a primary care-led NHS. That will continue to be the case, but, if others choose another means and manage to learn from the best practice that has been made available by GP fundholders, I welcome that.