Primary Care Groups

HC Deb 04 May 1999 vol 330 cc686-8

2. Mr. Denis MacShane (Rotherham)

If he will make a statement on progress in the introduction of primary care groups. [81808]

The Secretary of State for Health (Mr. Frank Dobson)

Four hundred and eighty one primary care groups came into operation on 1 April. I pay tribute to the hard work of all those who have made possible that voluntary change, and I congratulate general practitioners on agreeing for the first time to share decision making on primary care with other professions and lay people.

Madam Speaker

Am I to understand that Question 3, tabled by the hon. Member for Altrincham and Sale, West (Mr. Brady), is to be linked with Question 2?

Mr. Dobson

If you wish it, Madam Speaker.

Mr. MacShane

I welcome my right hon. Friend's reply. Has he had a chance to read the new paperback book called "Satan's Children", written by the Opposition deputy spokesman on health, the hon. Member for Rutland and Melton (Mr. Duncan)? On page 319 there is a reference to the need to impose charges on users of the NHS as a deterrent. Will my right hon. Friend repudiate such nonsense and the other nonsense from the queen of the underworld—the shadow Secretary of State—and her exotic sidekick?

Madam Speaker

Order. A little more temperate language would be in order.

Mr. MacShane

I apologise, Madam Speaker. Does my right hon. Friend welcome the sensible speech of the right hon. Member for Hitchin and Harpenden (Mr. Lilley), which almost seemed to be on the new Labour wavelength? Will my right hon. Friend consider the training of primary care groups, as the training of all involved in the partnerships—from GPs to receptionists—must be an integral part of making PCGs work? Will he instruct his officials to ensure that training is a part of the PCG programme in the future?

Mr. Dobson

I hesitate to correct my hon. Friend, but I believe that the book to which he referred is called not "Satan's Children" but "Saturn's Children"—which may account for the fact that the Tories seem to be running rings around one another all the time. They are certainly not running rings around any one else.

I will consider the question of the training of those serving on the boards of primary care groups. I believe that some training has been provided. Now that the PCGs have been established, I expect that the time taken by those serving on the boards will be reduced. We all know that a process of change or take-off is rather more time-consuming than what happens when one is cruising along. The PCGs are now established, and most are cruising along effectively.

3. Mr. Graham Brady (Altrincham and Sale, West)

If he will make a statement on appointments to primary care group boards. [81810]

The Secretary of State has clearly forgotten that he asked for Questions 2 and 3 to be linked. He has also forgotten, apparently, that it is customary in the circumstances to attempt to answer both questions, not just one. [HON. MEMBERS: "Get on with it."] That is very rich coming from Labour Members. The Secretary of State made not even a passing reference to appointments to primary care group boards.

Given the information that has come to light already—that, in respect of appointments to health authorities and trusts to date, 84 per cent. of the councillors appointed have been Labour councillors—is it not ludicrous that the Department, in a written answer on 19 April from the Minister of State, Department of Health, the hon. Member for Southampton, Itchen (Mr. Denham), told me that it did not even intend to provide information about the political affiliation of those appointed to primary care groups? Is it not obvious that the Secretary of State is adding to the scandal of the political bias of the appointments made by the Department a further scandal—that of attempting to cover it up?

Mr. Dobson

Since Labour took office, 50 per cent. of the appointments to NHS boards have been women—a step in the right direction—and 11 per cent. have been black or Asian, which is one way of dealing with the institutionalised racism in the health service that we inherited from the Conservative party. As for primary care groups, we do not keep records because the bulk of the members of the groups are elected by GPs. It would be wholly improper for me to inquire into the political affiliation of the people whom GPs or local nurses elect to represent them on the boards of primary care groups.

Mr. David Borrow (South Ribble)

GPs in my area of south Lancashire were involved in the pilots that operated prior to 1 April, and they were enthusiastic supporters of the change. However, they are concerned that the structures under primary care groups are too prescriptive. Will my right hon. Friend consider allowing more local flexibility as the new system beds down, to allow a greater recognition of the differences between one locality and another?

Mr. Dobson

I certainly wish to do that. Most of the detailed advice that we provided was at the request of the British Medical Association and the Royal College of General Practitioners which, at almost all stages, asked for further and more detailed guidance than we were giving them.

Miss Ann Widdecombe (Maidstone and The Weald)

How much confidence can primary care groups have in their local hospitals when junior doctors will be obliged to work 65 hours a week instead of 56? If that is not the case, why did the Secretary of State propose it to the European Commission?

Mr. Dobson

We did not propose that to the European Commission. We are not proposing that any junior doctor should work longer hours than at present. The right hon. Lady knows that, and she should stop pursuing this daft line of argument.

Miss Widdecombe

If that was not proposed to the European Commission, why have I received a statement that says: The British proposals were put forward at a meeting of officials in Brussels yesterday in advance of their meeting later this month. European Commission officials said they were 'shocked' by the British stance on junior doctor hours. A Commission spokeswoman said: 'We are not talking about Turkish carpets here—we are talking about junior doctors' health and safety, and the lives of their patients.'"? If there has been no proposal, how does the Commission know about it, and why does it say that there has been such a proposal?

Mr. Dobson

I find it extraordinary that a member of the anti-European Tory party should quote with approval criticisms of the Government of a sovereign state by a public official of the European Union.

Talks are going on in Europe in which the various Governments are considering the impact of the working time directive on doctors in their countries. We should be judged not by what is happening now but by how we end up. We are determined to end up with a system in which our junior doctors—and the interests of the national health service—are properly protected, and are not trapped by any rigidities imposed from Brussels.

Miss Widdecombe

When the European Commission says that it received a proposal from the British Government yesterday to raise junior doctors' hours from 56 to 65, is it misleading us, or is the Secretary of State having an incredible fit of imagination?

Mr. Dobson

Neither. As far as I know, the European Commission has not issued any official response to what we have said. Certainly, no one with any authority has done so.