HL Deb 17 March 1994 vol 553 cc381-2

3.6 p.m.

Lord Stallard asked Her Majesty's Government:

Whether the implementation of the annual screening by their GP of people aged 75 and over is being monitored and whether the information about the health of the older population emerging from the screening scheme is being gathered and evaluated centrally.

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

My Lords, the purpose of screening people of 75 and over is to enable general practitioners to provide them with the best possible care. Local monitoring of general medical services is carried out by family health service authorities. There is no requirement to collect the information centrally.

Lord Stallard

My Lords, I am grateful to the noble Baroness for that reply. Can she confirm that the requirement to carry out the screening tests was inserted into GPs' terms of reference in 1990? In fact it was explicitly mentioned in the Patient's Charter that people had a right to an annual visit if they were 75 or over. Is she aware that various surveys and reports which have recently come to light show that there has not been universal implementation of the checks? Can that be confirmed by the department and can pressure be brought to bear on those GPs who are not carrying out the checks? What is important is that the information gleaned from the checks should be used to enable us to plan future services and resources for the health and care needs of the elderly.

Baroness Cumberlege

My Lords, as I understand the position, everyone over 75 is offered an invitation to have a health check. But the way that the check is done is not standardised. It is done in different ways in different places. We are reviewing it at the moment and there will be a submission to Ministers in due course.

Lord Carter

My Lords, can the Minister assure the House that where the annual screening of people over 75 reveals a need for the provision of services, both the health service and care providers have an obligation to provide individuals with those services? Are the Government satisfied with the situation revealed by the recent survey of the Royal College of Nursing? It showed that one in four of the elderly people most at risk are not receiving any form of statutory service.

Baroness Cumberlege

My Lords, when needs are detected in people over 75 and, indeed, at other ages it is up to social services and health authorities to try to meet those needs within the resources available.

Baroness Jeger

My Lords, has the noble Baroness no way of finding out how many GPs are not informing their patients of 75 years of age of the right to request attention under these provisions? To my knowledge there are very many patients who do not know about these provisions and whose GPs take no steps to inform the patients of their rights.

Baroness Cumberlege

My Lords, I shall certainly look into that matter. As I understand the position, if a person aged 75 or over is on a GP's list, then that person is invited to the local practice for a check.

Baroness Fisher of Rednal

My Lords, does the noble Baroness agree that it is important for the information to be collected and evaluated so that provision can be made for the patient's care in the community or acute hospital care? Does she further agree that if the tests are not done, the evaluations are not brought forward? How, therefore, can the Government plan the services for them?

Baroness Cumberlege

My Lords, the main purpose of the check is to enable GPs to give appropriate care to elderly patients on an individual basis. Some family health service authorities are collecting the information on local needs and using it in terms of purchasing. Other research is taking place. At the moment the Medical Research Council is conducting a trial. Professor Phillips, now at Sheffield University, did some research in Southampton. Professor Idris Williams, a professor of general practice at Nottingham Medical School, is also undertaking some research. In addition, some local research is being done in north Kensington. I know that there are other schemes as well. So, although the information is not being collected centrally, it is certainly being used in research projects. But we have to be careful. If we ask GPs to collect more and more information and to submit more and more central returns, it means that they have less time to give to patients. We are anxious to reduce the bureaucracy.

Lord Ewing of Kirkford

My Lords, can the noble Baroness advise me whether these tests are available from the doctor who looks after the Palace of Westminster? If that is the case, would he need to employ extra staff to take care of your Lordships' House?

Baroness Cumberlege

My Lords, the test covers sensory functions, mobility, mental condition, physical condition, social environment and the use of medicines. When I look around the Chamber, I believe that noble Lords are in excellent condition.