HL Deb 30 June 1993 vol 547 cc804-5

2.54 p.m.

The Countess of Mar asked Fier Majesty's Government:

Whether it is their policy to reduce the number of small general medical practices in rural areas.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, no.

The Countess of Mar

My Lords, I thank the Minister for that reply which I had half expected. Is she aware that the parameters laid down for fund-holding practices, the methods by which special clinics are paid for, the reimbursement for computerisation, and the means by which dispensing doctors are repaid for drugs and containers are steadily undermining the practices of rural doctors which will very soon become unviable. What do the Government propose to do to ensure that those practices remain viable and that the patients in those practices receive equal treatment with patients in urban areas?

Baroness Cumberlege

My Lords, the Government have a general practice payment scheme as well as an inducement payment scheme for doctors in rural areas. Fund-holding practices already make up 20 per cent. of the rural practices. That compares very well with the proportion for the country as a whole of 14 per cent.

Lord Williams of Mostyn

My Lords, yet again perhaps I may endorse the monosyllable which was the first Answer. Will the Minister bear carefully in mind that the small general medical practice in rural areas is of exceptional importance? It is an important central strand in the life of those communities. Not everyone has a motor car, and public services generally are decaying. To sustain those practices is of paramount importance.

Baroness Cumberlege

My Lords, I thoroughly endorse everything the noble Lord says. It is because of that commitment that the Government have ensured that GPs are better paid and better equipped and that they have stronger primary health care teams with more ancillary staff and more practice nurses. In my view they have never done the job better.

Baroness Masham of Ilton

My Lords, does the Minister agree that in isolated rural areas there can be a problem of getting cover for GPs for holidays and time off? Does she agree that GPs need more help and support rather than less and that the problem of a two-tier system might arise?

Baroness Cumberlege

My Lords, the noble Baroness is absolutely right. We are aware of problems that rural GPs have in terms of cover. That is why in 1991 we introduced a revised scheme for GP rural practice payments. It is being reviewed at the moment. I believe that it has been successful.