Primary Care (Hansard, 9 December 1997)

§ 1. Mr. Pond
What proposals he has for increasing the role of primary care within the NHS. [18227]

§ 12. Mr. Prosser
What proposals he has for promoting the role of primary care. [18240]

§ The Secretary of State for Health (Mr. Frank Dobson)
The development of primary care is one of the Government's medium-term priorities for the NHS. We recently launched a salaried doctor's scheme which will improve the quality of services and help tackle health inequalities. From 1 April next year, health authorities will be able to fund local development schemes to improve general medical services. We also intend to proceed with pilots under the National Health Service (Primary Care) Act 1997 to explore more flexible ways of delivering primary care. Our further proposals will be set out in the White Paper to be published at 3.30 pm today.

§ Mr. Pond
I thank my right hon. Friend for his reply. Is he aware that general practitioners in my constituency of Gravesham and in the constituency of my hon. Friend the Member for Dartford (Dr. Stoate) have recently developed a highly successful scheme of co-operation? Is he further aware that we have recently opened a minor injuries unit in Gravesend and North Kent hospital, again managed by nurses and GPs, as the first stage to establishing a proper community hospital in the borough? Is not the way forward for the health service putting GPs and nurses in the driving seat and ensuring that they can match local decisions to local needs?

§ Mr. Dobson
What my hon. Friend says is true and very welcome. Such developments, which we have been looking at and studying, make us confident that the proposals that 778 we shall be introducing this afternoon are going with the grain of the people within the NHS, who are trying to develop better and better services for local people.

§ Mr. Prosser
Does my right hon. Friend agree that most patients look upon their local nurses and health care professionals as the linchpin of the NHS? Can he assure me that he wants to see places such as Aylesham health centre, Deal hospital and Buckland hospital in my constituency flourish and expand?

§ Mr. Dobson
What is wanted is a first-class health service, close to home so that people do not have to travel long distances to find primary care, community care and community hospitals. That is what is wanted increasingly by local people and the profession, and we want to help them bring it about.

§ Mr. Rowe
Is the Secretary of State aware that his emphasis on primary care will be widely welcomed? At a time when the responsibility for developing the health service is shifting increasingly to primary care, is there not something absurd about carrying on the kind of rationalisation of hospitals that is going on now, without any reference to GP preferences? For example, in Kent, the Kent and Canterbury hospital and others are under threat.

§ Mr. Dobson
As everyone knows, the number and nature of hospitals in the NHS has been changing since the NHS came into being. We are determined to ensure that any changes reflect the needs of people living in a particular area. As I understand it, in the area represented by the hon. Gentleman, the proposals are out for consultation. The new Government want to move to a situation where consultation is genuine and not just a period of time.

§ Mrs. Virginia Bottomley
Is the Secretary of State aware that Professor Howard Glenerster has suggested that GP fundholding has caused a shift in the balance of power back to GPs for the first time this century? Is the right hon. Gentleman committed to doing everything that he can to build on the success of GP fundholding and extend those opportunities to others?

§ Mr. Dobson
When our White Paper is published this afternoon, the right hon. Lady will see that we are trying to build on the parts that have worked and dispense with the parts that have not worked.

§ Ms Blears
My right hon. Friend will be aware that Salford has one of the new GP commissioning pilot projects. Despite its unfortunate acronym, the Salford health action group is working tremendously hard to improve the health of the people. Will my right hon. Friend tell us how important he thinks is the voice of patients and users in such projects?

§ Mr. Dobson
There are some who suggest that I am noted for my vulgarity, but never in the Chamber—or at least, not this Chamber.
My hon. Friend has made a crucial point. We need a national health service that is moulded to the needs of the patients, and the medical and nursing professions are as wedded as anyone to that concept. They are trying to liaise with local people to ensure that the services that 779 they provide meet the needs of local people. We are determined that our changes to the national health service will help to achieve that. I am sure that everyone will be better off as a result.