HC Deb 22 March 1995 vol 257 cc329-30
1. Mr. Wray

To ask the Secretary of State for Scotland what assessment he has made of the quality of management of health service trusts and fundholder practices in Scotland. [13626]

The Parliamentary Under-Secretary of State for Scotland (Lord James Douglas-Hamilton)

The quality of the management of NHS trusts and GP fundholding practices is assessed through their performance in delivering quality patient care. They have been most successful: more patients have been treated, waiting times have fallen and new services have been developed.

Mr. Wray

Does the Under-Secretary agree that fundholding practices in Scotland are a disgrace and that we do not want them? The Government have recommended that there should be 11,000 fundholding practices, but the amalgamation of some of them has brought the number down to 4,000. In fact, there are only 107 fundholding practices out of the 1,000 practices in Scotland. Trusts have turned the health service into a greyhound service. One of my constituents was taken to hospital with a heart attack at 3 o'clock in the morning. He was sent home alone, in a taxi dressed in just a robe. He was taken back to the hospital at 8 o'clock and died at 10 o'clock. That is a disgrace. The health service should be cleared up.

Lord James Douglas-Hamilton

On the unfortunate death of Mr. McGowan in January 1994, the three main recommendations addressed to the Government are being considered by the NHS executive. There are 22 intensive care beds in Glasgow hospitals. Following a review by Greater Glasgow health board, a further four beds have been funded and all aspects of the sheriff's findings at the fatal accident inquiry are being addressed.

We believe that trusts bring a great many benefits. Record numbers of patients have been treated. There are shorter waiting lists and waiting times and more information and choice is being given to patients. There are new services and improvements. GP fundholders have greater freedom and improved communications. They are providing more services and are developing new or improved services. At least 30 per cent. of the Scots population will benefit from their GP being involved in either standard fundholding or primary care purchasing.

Mr. Bill Walker

Is my hon. Friend aware that the majority of people of Tayside believe that our health service in Tayside is second to none anywhere in the world? A number of our GPs are fundholders and they, too, believe that they are providing a service that is second to none. Is not it time that we began to talk up the value of our health service and those who are dedicated to it and work in it instead of constantly attacking it?

Lord James Douglas-Hamilton

I agree entirely with my hon. Friend. I can announce today that for the relatively few cases where there are serious complaints, we are putting in place a new complaints procedure from April 1996 so that there will be a response from the provider of the service, the opportunity for a review of the complaint by a panel with an independent lay chairman and recourse to the health service commissioner. We feel that that will greatly assist in the few cases where there are legitimate complaints.

Dr. Bray

The public have a duty not to abuse the health service, but will the Minister keep an eye on any tendency by fundholding practices or other general practices to purge patients from their lists in a wholesale manner?

Lord James Douglas-Hamilton

We believe that there are substantial benefits to be gained from GP fundholding. We believe that it will result in a better service for the patients concerned. We do not want to see a deterioration of service, which is the hon. Gentleman's point.

Mr. McAllion

Are we still dealing with the management of a genuinely national health service? If we are, how can the Minister justify the introduction of local pay bargaining, which means that nurses and midwives in one part of Scotland will be paid less than those in other parts? Since that cannot be justified, will the Minister take the opportunity to announce that he is scrapping local pay bargaining and instructing the management of every NHS trust in Scotland to pay the full 3 per cent. to all nurses and midwives, with no strings attached? If he is not prepared to announce that, will he attend one of the rallies to be held across Scotland on 30 March by nurses and midwives, at which he will be able to explain to them face to face why national pay bargaining in the NHS is good enough for consultants and doctors but not for nurses and midwives?

Lord James Douglas-Hamilton

The hon. Gentleman should be clear that under the management allowance for GP fundholders some 2 per cent. of overall funds for patient care are managed by fundholders. It is not a payment for GPs, but a reimbursement of their administrative costs. Obviously, those at the sharp end of the health service should be paid the going rate for the job.

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