HC Deb 18 March 1997 vol 292 cc710-2
4. Mr. Michael Brown

To ask the Secretary of State for Health if he will make it his policy to require all general practitioners to become fundholders. [19164]

The Secretary of State for Health (Mr. Stephen Dorrell)

The general practitioner fundholding scheme is, and will remain, voluntary. With effect from 1 April this year, 58 per cent. of patients will be registered with a fundholding GP.

Mr. Brown

My right hon. Friend says that the scheme will remain voluntary. Does he agree, however, that fundholders are able to offer increased opportunities for treatment at their surgeries rather than at a hospital? I have visited the Barton-Upon-Humber surgery, which is a fundholding practice in my constituency. It is able to deliver patient care, ensuring that patients do not have to go 20 miles down the road to a hospital at Grimsby or Scunthorpe. The practice is able to offer what used to be regarded as cottage hospital treatment. Many treatments are now available from fundholders. Will my right hon. Friend think again about making the scheme available to all patients?

Mr. Dorrell

My hon. Friend is entirely right about the benefits for patients of the fundholding scheme. He quoted a typical example; there are many others throughout the health service. Over the next few weeks, the question for the Labour party is why it supports the abolition of a scheme that has brought about the benefits to which my hon. Friend referred. The hon. Member for Islington, South and Finsbury (Mr. Smith) is quite specific. A Labour Government would abolish fundholding. That would neuter Britain's GPs and be a major step backwards in the provision of health care. The burden is on the hon. Gentleman to explain why he wants the health service to take that gigantic step backwards.

Mr. Spearing

Does not the Government's version of fundholding introduce elements of competition which undermine the principle of universality? Is not that principle founded on an injunction of 2,000 years ago, to bear each other's burdens? When will the Government put that into practice in the health service in the next millennium?

Mr. Dorrell

It is extraordinary that, when we introduce a scheme that improves care for the patients of fundholding doctors and which the majority of Britain's GPs adopt because they believe that it is in the interests of their patients, Labour's reaction is to want to abolish the scheme that has made those improvements possible. I simply fail to understand how the Labour party can say that the right way forward for the health service is to abolish a scheme that has brought about the improvements to which my hon. Friend the Member for Brigg and Cleethorpes (Mr. Brown) referred.

Mr. Mans

My right hon. Friend will be aware that, in Lancaster, all doctors have fundholding practices. Does he agree that, if the system were abolished, patient care in north-west Lancashire would be severely affected—and would be a lot worse?

Mr. Dorrell

My hon. Friend is entirely right. In his constituency, in Lancashire, and around the country, fundholding is delivering improved patient care not only to the patients of fundholding GPs, but to every patient of the health service, because it has changed the relationship between primary and secondary care, to the advantage of primary care.

The hon. Member for Islington, South and Finsbury seems to disagree. He should look at a press release from the British Medical Association published this morning in which the BMA and the representatives of general practice in Britain came together and made it crystal clear that they support the continued existence of a range of options for Britain's GPs. That is the position of the BMA and of the representatives of Britain's GPs. The Labour party must explain why it believes it knows better than the majority of Britain's GPs what is in the interests of their patients.

Mr. Simon Hughes

As the system created as a result of the Government's reforms unfairly allocates money to GPs depending on whether they are fundholders and has produced a two-tier service for patients depending on whether their doctors are fundholders, will the Government modify it, which fundholders would willingly accept, so that, no matter which GP people go to, they have equal access to the health service, or will the Secretary of State go into the election defending a two-tier health service which is a national health lottery for Britain's patients?

Mr. Dorrell

I am going into the general election campaign defending a system of totally fair funding across all parts of the NHS—whether GP fundholders or not. I take it as significant that, on this question about fundholding, the hon. Member for Islington, South and Finsbury and all his hon. Friends have remained firmly seated. They are not prepared to engage in the argument about fundholding in Britain, because they know that they are on a loser.

Mr. Dunn

Is my right hon. Friend aware that there is tremendous public support for GP fundholding in my constituency? Will he confirm that the Labour party's policies are contrary to the health needs of my constituents, and will work against them in the long term?

Mr. Dorrell

Once again, my hon. Friend is right. He highlights the fact that the Labour party adopts only policies that would impose a single bureaucracy across the entire country. The idea that there may be advantage in different approaches in different localities, reflecting the different choices of GPs and their patients, is utterly foreign to the Labour party. It will never win the argument, and is no longer even prepared to engage in it.