The Acheson Report: Primary Health Care (Hansard, 6 July 1982)

§ Lord Hunter of Newington
My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

§ Lord Lyell
My Lords, we are actively considering the Acheson Report in the light of the many comments which we have received on it, and we hope to make an announcement soon.

§ Lord Hunter of Newington
My Lords, in thanking the noble Lord the Minister for that reply, may I ask that steps be taken, as I am sure they may well be, to bring the report to the attention of the new district authorities? Also perhaps one would like to know whether the reorganisation of the administration of the National Health Service will improve the situation in London, particularly in view of the Written Answer given in another place by the Minister of State for Health and Social Security on 17th November, that establishing family practitioner committees in their own right with powers to engage their own staff, this is likely to facilitate the development of primary care services and lead to increased efficiency in the administration of family practitioner services".—(official Report, Commons, col. 112.) One cannot but remember that the Acheson Committee believed that an effective integration of services was required for effective primary care.

§ Lord Lyell
My Lords, as far as the noble Lord's first question is concerned, indeed we shall bring the report to the attention of regional health authorities and any other interested bodies where they are not already aware of the report with all its findings and conclusions. We believe that they are very well aware of that.
So far as the noble Lord's second question is concerned, I take the quotation that he has made; I note it, but I would not be able to comment on it in detail at this stage. I am sure the noble Lord and indeed your Lordships will be aware of the five main recommendations contained in the Acheson Report, which are all very closely concerned with primary health care and community care in urban areas.

§ Lord Wells-Pestell
My Lords, may I ask the noble Lord the Minister whether he will indicate to the House what steps the Government have taken to secure comments and observations on this report? I rather got the impression from the noble Lord's reply to my noble friend that the Government were prepared to consider any comments and observations, but are the Government taking steps to secure comments and observations from informed individuals and informed groups?

§ Lord Lyell
My Lords, I hope that there is not much difference between the reply which I gave to the noble Lord, Lord Hunter of Newington, and what the Government are doing. I am sure that the noble Lord, Lord Wells-Pestell, will be pleased to know that both the Acheson Report and indeed the associated Harding Report have been very actively considered together, and so far we have received comments from 64 different and important organisations on the Acheson Report, and over 100 on the associated report by Dr. Harding.

§ Baroness Faithfull
My Lords, in that case I should like to ask my noble friend the Minister whether an approach has been made on a co-ordinated basis, and whether the social services together with the health authorities have been approached on the implementation of this report?

§ Lord Lyell
My Lords, I am not aware of any specially co-ordinated approach, but I am given to understand that there have been informal discussions with the General Medical Services Council, and over 50 of the recommendations in the Acheson Report relate to pay and conditions of service for general practitioners. Indeed, discussions have concentrated on various issues such as retirement age for general practitioners together with various other major issues which are found in the Acheson Report. There have also been discussions with regional nursing officers on various other proposals for improvements in primary health care nursing.

§ Lord Cledwyn of Penrhos
My Lords, there is a certain uncharacteristic lack of clarity about the noble Lord's replies to this Question. Can he say clearly to the House that an initiative has been taken by his right honourable friend? He talks about letters having been received—40 letters from here and 30 letters from there. Are those letters in response to a request from his right honourable friend? Is it not necessary, if co-ordination is to take place, that the co-ordinator should be the responsible Minister? Can he say that, in fact, the initiatives taken from above are not in some haphazard way from below?

§ Lord Lyell
My Lords, the noble Lord attempts to flatter me for my first attempt at replying for this particular sector of the Government. I hope that I have been nothing less than truthful. I hope that I have been as clear as I can be. Indeed, the noble Lord mentioned over 40 letters. I said 64 letters and 100 letters, and so I hope that I was clear on that particular aspect. No, we have received the report and my 656 honourable friend in another place, if I may quote him, said: This report not only points out the special problems in London, but also shows ways to improve London's health services". He continued: I am sure that this is the way to get a better medical service to the people of London". My honourable friend is very willing to receive communications and, indeed, observations and views. I hope your Lordships will agree that it is not necessary for my honourable friend to go out actively to seek responses. Indeed, 164 replies for two reports is nothing short of active response by those interested.

§ Baroness Gardner of Parkes
My Lords, would my noble friend confirm that in all consideration of health matters dentistry is also fully considered? I must declare an interest here as an inner London practitioner. Would my noble friend confirm that medicine cannot be viewed separately from the other parts of the health service as regards primary care?

§ Lord Lyell
My Lords, I am not aware as to whether dentistry is covered by the Acheson Report or, indeed, by the definition of "primary health or community care". I am afraid that I am not able to answer that point. Perhaps I may discover the answer and write to my noble friend.

§ Lord Wells-Pestell
My Lords, can the Minister tell the House whether the Government have accepted in principle the recommendations and observations of the committee?

§ Lord Lyell
My Lords, perhaps I could not go so far as to say that we have accepted every comma and every dot in each of the reports, but I could say—I hope that the noble Lord and the House will accept this —that we have welcomed the reports.