General Practice (Hansard, 4 November 2003)

§ 9. Kali Mountford (Colne Valley)
How many general practitioners are in training; and if he will make a statement. [135977]

§ The Secretary of State for Health (Dr. John Reid)
There were 2,157 general practitioner trainees in June 2003. That is an increase of 814 since 1997, and the highest number ever in the history of this country. We promised more GPs, and we have kept that promise.

§ Kali Mountford
I thank my right hon. Friend for that answer, and for his efforts in ensuring that general practice is an attractive option for trainee doctors. In my constituency, however, one GP vacancy was advertised for 18 months before being filled. As we approach the winter months, everyone is more acutely aware than ever of the need for GPs. Will my right hon. Friend redouble his efforts with the royal colleges and the British Medical Association to improve capacity yet further?

§ Dr. Reid
Yes, I shall certainly do as my hon. Friend suggests. The truth of the matter is that we have achieved our initial trainee target ahead of schedule; as I said, there were 2,157 GP trainees as of June this year—highest number ever recorded. However, there is no doubt in my mind that we need to achieve a great deal more than that, not least because of the underinvestment during the 20 years before the Government took office. To point that out is not to make a party-partisan point, because every one of the 1.3 million people in the NHS and the 60 million people of this country knows the truth: the NHS was starved of investment. That is why, in a paradoxical fashion, I can tell my hon. Friend that we have the highest number of doctors in history, yet the number is still insufficient, because we are making up for the lost decades under the Conservatives.

§ Dr. Liam Fox (Woodspring)
When the Prime Minister talks about public services, he says that it is about schools and hospitals. What message does that send to those who work in primary care, who deliver the majority of health care?

§ Dr. Reid
First, may I congratulate the hon. Gentleman both on his incipient move and on actually asking me a question? Since I became Secretary of State, that is the first time—

§ Mr. Simon Burns (West Chelmsford)
Rubbish.

§ Dr. Reid
It is the first time since I became Secretary of State that the hon. Member for Woodspring (Dr. Fox) has fulminated inside the Chamber rather than outside it.
As for what we said we would do, we did not say only that we would build more schools and hospitals, although that is true. We said that we would create more doctors and that we would have more nurses and more midwives. We said that we would have shorter waiting times, that we would put in more money and more hospital equipment, and that we would build more hospitals and buildings than ever before in the NHS. I am glad to say that we have done each and every one of those things. There are 55,000 more nurses, ahead of target. We have 6,500 more consultants and thousands more doctors—more than ever—and the biggest building programme in the history of the NHS. We have the biggest sustained investment increase, at 7.4 per cent. in real terms, for the longest period in our history. We 663 made the promises and we kept the promises, yet every one of them would be destroyed by the Opposition and their plans to cut back on the national health service.

§ Dr. Fox
That was an interesting answer, but not to the question that I asked. My question was about what Government soundbites tell us about their approach to the acute sector in relation to the community sector. There is poor morale in primary care, so let us see whether the Secretary of State can actually answer me in detail. One in six doctors currently in general practice graduated from a south Asian university; two thirds of them will retire by 2007. How many extra doctors will be required to fill those posts? A recent study by the British Medical Association found that 20 per cent. of all GP time is taken up by administration. How many doctors does that effectively take away from patient care? According to the Government's figures, the number of doctors per thousand patients has gone down since 1997, not up. When will the Secretary of State answer the real questions instead of giving us soundbites, statistics and complacency?

§ Dr. Reid
Well, if ever I heard a soundbite it was "soundbites, statistics and complacency", which does not quite match "Veni, vidi, vici" in the resonance of historical sweep. When the hon. Gentleman asked his question, he implied that we had merely promised more "schools and hospitals". That was his first soundbite, so he did not like being told about more doctors, more nurses and more midwives. Of course—[HON. MEMBERS: "Answer the question."] I will, therefore, answer the questions. We have more doctors than ever in history. We have recruited some of them from overseas, not least because under the crowd on the Opposition Benches all the investment in doctor training was run down, unlike the situation under the Labour Government. In primary care, we have—[Interruption.] The Opposition can bay as much as they like; the truth is that we all know that all the increases in primary care, public health, secondary care, chronic care and care for the elderly would be destroyed by their reduction in investment and their criminal plans to charge our old folk up to £10,000 for their—

§ Mr. Speaker
Order.

§ Ms Joan Walley (Stoke-on-Trent, North)
May I say that my constituents are not interested in the sound bites that come from the Opposition? What they are interested in is being able to see a GP when they need to. Although I applaud the extra 814 GPs that are in training, may I tell my right hon. Friend that there is a serious short-term problem? We have had too many GPs retiring, and we need to attract more into part-time work. We need to ensure that we can deal with the immediate emergency crisis that we have, certainly in Stoke-on-Trent. Will he look at that and consider how the Government can support what the Stoke-on-Trent, North PCT is doing at the moment?

§ Dr. Reid
Yes, I will certainly look at that, and I do not for a moment underestimate the challenge, even with the record number of doctors that we have. I have already said that, because of expansion, retirement, past under-investment and other factors, there is a huge problem and we need to recruit even more. That is why, 664 although we are on course to deliver our target of 2,000 extra GPs, we need to do more. There has been an unprecedented expansion in medical school places in England: 2,150 more places were announced between 1999 and 2001, so that increase will contribute to the future number of GPs.
In addition, we are expanding our health service at a rate that is unprecedented in the past three decades, and people's expectations and ambitions are becoming greater. People now expect to see a GP within two days; they do not want to wait. People expect to have their operations a lot more quickly than when the Conservatives contemplated, as they said, a maximum waiting time of two years. We now have virtually no one waiting more than one year, and, by next year, virtually no one will be waiting more than six months. That will still be too long. We need more doctors, more nurses and more facilities in the NHS, all of which needs more investment. That is precisely what we will do, compared with the Conservative party.

§ Rev. Martin Smyth (Belfast, South)
I welcome the improvement. How many of the university posts that have been opened actually spring from a decision taken many years previously? I discovered that universities that were supposed to be opening more places for medical training were not doing so. How many training posts have not been occupied by young people who want to become GPs? Such vacancies have been one of the standing failures of our medical training for many years.

§ Dr. Reid
On the first question, frankly, I cannot tell the hon. Gentleman the answer off the top of my head, but I will write to him about that. On the second point, if I understood the question, he was implying that the great demand for places at medical schools or universities was not being met because such places were not available. All I can say to the hon. Gentleman is that we have carried out the most rapid expansion in places. We have four new medical schools, for instance. I visited one of them only a couple of weeks ago, welcoming another 120 young people coming in to train as doctors. A greater problem than the lack of places is the fact that there are cyclical trends. Sometimes large numbers of people who train as doctors choose to go into general practice and, at other times, they do not choose to do so. We are attempting to attract more people into general practice, not least through the recent new contract, which gives opportunity and flexibility to GPs and was overwhelmingly accepted by the profession itself.

§ Mr. Speaker
Order. We have five minutes left, and we are only at Question 9 on the Order Paper. The next time that we have Health questions, I do not want the record to be full of what the Opposition did when they were in power. Questions should be answered briefly, and that is the end of it.