GP Fundholders: Scottish Office Reception (Hansard, 17 January 1995)

§ The Minister of State, Scottish Office (Lord Fraser of Carmyllie)
My Lords, the purpose of the reception which I gave in Edinburgh on 25th November was to thank general practice fundholders in Scotland for the significant contribution they make towards achieving a patient-centred health service; and to make an announcement about important changes to the fundholding scheme. One hundred-and-twenty people were invited and around 70 attended, at a total cost of just over £1,000.

Lord Bruce of Donington
My Lords, I thank the noble and learned Lord for that reply. Can he inform the House why the reception was held in Edinburgh Castle? Does the total cost indicated by the Minister include the cost for extra heating at this time of year? The castle tends to be draughty. Will the noble and learned Lord further explain to the House why, at a time of increasing stringency in government expenditure going right down to the nooks and crannies of government, it was decided to give this form of entertainment to a restricted class of doctors in the medical profession?

§ Lord Fraser of Carmyllie
My Lords, I should explain to the noble Lord that we regularly use Edinburgh Castle for receptions attended by all types of domestic groups and in particular when we have foreign visitors. The gatherings can be very large or of the size I indicated. The figure I gave represents, so far as I can ascertain, the total cost of holding the event. I hoped that I had explained in my original Answer to the noble Lord why I held the reception. Not least, my purpose was to thank those people; but also, importantly, it was to indicate that changes were to be introduced which would be attractive to those wishing to expand their service in the best interests of their patients.
On expenditure, the noble Lord may recall that in November last year the Mail on Sunday reviewed hospitality expenditure by government across Whitehall. I am sure that he is as pleased as I am to see that the Scottish Office achieved a reduction of some 2 per cent., compared with other departments.

§ Baroness Carnegy of Lour
My Lords, does my noble and learned friend agree that the ministerial team of the Secretary of State for Scotland frequently gives receptions in Edinburgh Castle? It is a very attractive venue. The receptions are for various groups of people who are helping to develop public policy in Scotland. Does my noble and learned friend agree that the functions are widely appreciated? Not only that, but 534 those of us who have had the privilege of attending the receptions will guarantee that not much money is spent on central heating.

§ Lord Fraser of Carmyllie
My Lords, we in the Scottish Office would like to have a reputation for frugality in our expenditure on hospitality, without reinforcing the national stereotype of being mean. It is absolutely correct to say that we use the castle regularly. The last function I attended before the one we are discussing was held to thank people the length and breadth of Scotland who had helped the police catch criminals and the like. That is the kind of occasion for which we make use of Edinburgh Castle, and I believe it to be appropriate.

§ Lord Richard
My Lords, is the Minister aware that when I saw the Question on the Order Paper, I felt obliged to turn to my noble friend Lord Stoddart and ask him what conceivable relationship it had with Brussels? I am delighted to hear from the Minister that there is none.

§ Lord Fraser of Carmyllie
My Lords, I am grateful to the noble Lord. I shall ensure that if I hold a reception which has any European connection, there will be no publication of the event in The Times.

§ Lord Stodart of Leaston
My Lords, does my noble and learned friend agree that many Members of this House are envious of the fact that Scotland has a location like Edinburgh Castle in which to hold such entertainments?

§ Lord Fraser of Carmyllie
Very much so, my Lords. It has always been my experience that, curiously, such a reception in the winter months is even more impressive. Once our guests reach the courtyard at the centre of the castle—particularly if there is mist from the east coast swirling—I have the impression they realise they have arrived somewhere rather special. After that they particularly enjoy the limited hospitality we offer.

§ Lord Ewing of Kirkford
My Lords, what way is this to treat the general practitioner service in Scotland? Seventy general practitioners are told that if they join the Government's fundholding scheme they will receive an invitation to Edinburgh Castle and a lollipop from the Minister of State while many hundreds of other general practitioners doing marvellous work for their patients are totally ignored. Will the Minister make it absolutely clear that the work of all general practitioners the length and breadth of Scotland is appreciated by the Government and that the Government are not trying to drive a wedge between GP fundholders and non-fundholders?

§ Lord Fraser of Carmyllie
My Lords, I am very happy to offer that reassurance. I recognise, as I believe the noble Lord knows, that the focus of our attention within the National Health Service during the past year has been on primary care. We require the active participation of general practitioners across Scotland to achieve that; I acknowledge the great work they do. The scheme I announced that evening seems to have 535 attracted the attention of general practitioners in Scotland. I am very pleased to say that, since 25th November, there have been no fewer than 80 expressions of interest in the new primary care purchasing initiative that I announced.

§ Lord Ennals
My Lords, I have no objection at all to Edinburgh Castle. It is an admirable place in which to hold receptions; I much enjoyed doing so myself when I was a Minister. I want to follow the point made by my noble friend Lord Ewing. Why was it decided that the reception should be just for fundholders? Why was it not open across the board to general practitioners, or to general practitioners from some particular area of the country? Does the Minister agree that the role of general practitioners in our primary health care services is extremely important? Does he accept that any thought of a special bonus for those who are fundholders requires an explanation?

§ Lord Fraser of Carmyllie
My Lords, as I have said more than once, the central aim of the evening was to announce to an audience with a specialist interest a number of changes that we proposed to introduce. I have acknowledged that general practitioners across Scotland do a very important job in the National Health Service. If I am not to be criticised for offering hospitality to doctors, I would be glad to hold receptions for general practitioners not only in Edinburgh Castle but throughout the length and breadth of Scotland.

§ Lord Carmichael of Kelvingrove
My Lords, can the Minister give any idea of the percentage of Scottish general practitioners who have become involved in the fundholding group? The impression I get—some of the university research work by Hagger and McAteer suggests this—is that there is resistance and even a fundamental objection among a very large number of Scottish GPs to becoming fundholders? Can the Minister give the House an idea of the percentage? Was that not one of the reasons why the party was held; namely, as a recruiting drive? Finally, have the changes that the Minister announced been published anywhere?

§ Lord Fraser of Carmyllie
My Lords, there are currently 107 operating fundholders in Scotland. They cover something like 20 per cent. of the Scottish population. As I indicated, since the changes to the scheme were announced we have received a further 80 expressions of interest. We anticipate that something like 30 per cent. of the population will be covered by fundholding practices during the year 1995–96.
The fundholders have made improvements in health care in Scotland. I single out Grampian where their combined pressure has brought about important changes in the way that patients have their X-rays done—by direct access on six days of the week. That was of 536 advantage, not just to the patients of fundholders, but to all National Health Service patients within the health board area.

§ Lady Saltoun of Abernethy
My Lords, if the reception had not been restricted to fundholders, would it not have cost a good deal more?

§ Lord Fraser of Carmyllie
Yes, my Lords.

Lord Bruce of Donington
My Lords, following the appreciative remarks that fell from the lips of my noble friend Lord Richard on my own Front Bench, will the noble and learned Lord note that there is substantial opinion in all parts of the House that the Scottish Office should be congratulated for having avoided the gross excesses that take place in Brussels, which some noble Lords appear to wish to condone? In accepting my congratulations that he should have had such an enjoyable evening personally, will the noble and learned Lord guarantee that Scotland will continue to compare favourably with the Commission in Brussels?

§ Lord Fraser of Carmyllie
My Lords, I congratulate the noble Lord on his ingenuity. I am sure that his noble friend wishes that he had not been so cheeky as to attempt to distract our attention. When it comes to excesses, I can only reflect that the official Treasury calculation would be that it has cost something like £300 to answer this Question. I hope that we shall not find ourselves indulging in greater excesses in the future.