HC Deb 16 July 2002 vol 389 cc147-50
6. Laura Moffatt (Crawley)

What assessment he has made of the effectiveness of newly formed primary care trusts. [67269]

The Minister of State, Department of Health (Mr. John Hutton)

Three hundred and three primary care trusts have been established and are now operational. The trusts will be accountable to the new strategic health authorities, which will assess their performance. In addition, the Commission for Health Improvement will undertake routine assessments in every NHS trust, strategic health authority and primary care trust.

Laura Moffatt

Does my right hon. Friend agree that our primary care trusts will be judged on how well they work with other organisations in the community to improve people's health and well-being? Does he welcome plans such as those of Crawley PCT to commission partnership posts jointly with social services and the local borough council, to get the very best out of the jobs and ensure that people understand that there is now a cohesive health system in our communities and that the power has gone back right to where it belongs, with our GPs?

Mr. Hutton

Yes, I agree strongly. One of the key jobs of the new primary care trusts will be to bring about the closer integration between health and social care that my hon. Friend described. Most of our constituents see health and social care as one system, and they want them better integrated. We will do all that we can in the Department to encourage that. We have already changed the legislation and we are putting in the investment to ensure that we get that closer integration. I had the good fortune of visiting my hon. Friend's constituency recently and had the chance to discuss this and other developments with the leaders of her primary care trust. They are doing a brilliant job, and so is she.

Mr. Nicholas Soames (Mid-Sussex)

I have no doubt that the Minister will wish to pay the same tribute to me.

I endorse what the hon. Lady said. I had a very good meeting last Friday with the chairman and chief executive of the new Mid Sussex primary care trust. What guidance does the Minister give PCTs for the Olympian decisions that they have to take on funding very worthy organisations that approach them for help in preventive health care, for example, such as Homestart? PCTs do not seem to have the money available, and perhaps the new injection of funds will improve that. What guidance is offered on the help that should go to admirable outside organisations that badly need the funds?

Mr. Hutton

In his own way, the hon. Gentleman does do a brilliant job. He has a long association with Crawley, too, but let us not dwell on that. I agree with him strongly about the important role that primary care trusts will play—actively, we hope—in supporting voluntary organisations and helping to improve the delivery of front-line services. There may be some disagreement on this point. He and many others may make the argument for devolution to the front line, which is absolutely right, but then ask us to issue guidance on how the functions should be delivered. There is a balance to be struck. There are key responsibilities for primary care trusts on which it is perfectly appropriate for Ministers to issue guidance—commissioning and a range of other important services—but we trust PCTs to make the right decisions. Their resources are growing substantially, with a 10 per cent. cash increase this year alone. That will also benefit him and his constituents. We want to leave the PCTs free to make their own decisions.

Dr. Brian Iddon (Bolton, South-East)

Under the previous health authority, my constituency was one of the most underfunded in the entire country. Now that we have the Bolton primary care trust, and following the Chancellor's excellent announcement yesterday, will my right hon. Friend assure my constituents that he will look again at the most underfunded areas in the country and bring them up to target faster than hitherto?

Mr. Hutton

My hon. Friend will be aware that my right hon. Friend the Secretary of State is currently reviewing the funding formula and the method of allocating resources across the NHS. I hope that we will be able to make appropriate announcements on that in the near future. Many hon. Members of all parties have raised this important issue with me. We must set ourselves the important objective of improving the health of the poorest members of our community at the fastest possible rate. That is the challenge for this Labour Government. We welcome that, and we will take it on—in stark contrast to the Conservative party, which could not even bring itself to mention health inequalities in the 18 years for which it had the stewardship of the national health service.

Dr. Liam Fox (Woodspring)

First, I thank the Secretary of State for his comments, the sympathy expressed to the family of the road traffic accident victim, and for his support in the past few days. It is a pity that the friendship and courtesy that typifies the way we do business in this place most of the time is not the face that the public see.

Yesterday, the Chancellor reiterated the Government's target of 48-hour access to general practitioners by 2004. To achieve that, the Government themselves said that they had to recruit 4,000 extra GPs between 2000 and 2004, yet the net increase in 2000 across England and Wales was 18, and in 2001 it was also 18. How are PCTs supposed to reach that target by 2004?

Mr. Hutton

If the hon. Gentleman looks at the progress that has been made in recruiting new GP registrars, for example, he will see that a substantial number of GPs—nearly 7,000—are in training. From that figure, I think that we can meet our target of recruiting a minimum of 2,000 GPs by 2004. Key to that aim is the investment that we are putting into the national health service. The hon. Gentleman expresses concern about the rate of progress in recruiting GPs, but I should point out in the politest way that I can that we will take him and his colleagues seriously when they are prepared to match the investment that we are putting in.

Dr. Fox

Doctors should be recruited into general practice because it is a career that they want, not bought from a GP supermarket. In the past two quarters, there has been a huge increase in emergency admissions through accident and emergency, totalling almost 100,000 above trend. To what does the right hon. Gentleman attribute that increase, and what does it say about the current interaction between general practice and the acute sector, and particularly the burden on GPs?

Mr. Hutton

We are investing significantly in improving our accident and emergency departments, but is it clear that the hon. Gentleman cannot match that investment. I remind him of what I said a moment ago about the number of GPs who are already entering GP training. That is the cohort from which we will meet our target of recruiting additional GPs for the national health service. Across the various areas that he has drawn attention to, we are making progress.

I am glad that the British Medical Association has been able to announce the result of the ballot of GPs on the new general medical services contract. Some 75 per cent. of GPs consider that a sensible way to reform the GPs' contract. That will provide us with a sensible platform from which to continue to improve primary care services, particularly the relationship between primary care and accident and emergency departments.

Dr. Fox

Those answers smack more than a little of complacency. PCTs have staff shortages, they have failed to reach their IT targets, they must repay their deficits this year, and thus they say that little or no money will be available for primary care development. They also have to shoulder the inappropriate role of public health, and on top of that, they are concerned about the Government's plans to push ahead with foundation hospitals. How will the relationship between PCTs and foundation hospitals differ from current relationships?

Mr. Hutton

Basically, the hon. Gentleman is criticising the Government's reform agenda for the national health service—our attempts to improve its efficiency, productivity and effectiveness. I repeat that we will take his concerns seriously when he can outline for us his reform agenda. Until he does so, most Government Members will be forced to reach the only rational conclusion: the bogus rhetoric of the Conservatives is a smokescreen for what we all know will happen if we ever have the misfortune to experience a Tory Government again. It will be cuts, cuts and cuts again.

Mr. Eric Illsley (Barnsley, Central)

As my right hon. Friend is aware, the primary care trust that serves Barnsley is the biggest in the country. Unfortunately, it started life in April 3 per cent. short of its funding target. That shortfall, which equates to about £6 million, has been compounded by a further £1.5 million debt, and by the shortage of GPs, which costs us money. Will he look again at Barnsley PCT's funding?

Mr. Hutton

I am afraid that I can only repeat what I said to my hon. Friend the Member for Bolton, South-East (Dr. Iddon). I am aware of the issue to which my hon. Friend draws attention, and my right hon. Friend the Secretary of State and all Ministers in the Department of Health are fully committed to addressing it. However, it is worth pointing out that, despite the problems to which my hon. Friend rightly draws attention, Barnsley PCT received a very significant increase in its resources this year. Our challenge and responsibility is to keep that investment coming through, and I can confirm that that is what this Government will always do.