NHS Plan (Hansard, 22 November 2000)

§ Lord Hunt of Kings Heath
My Lords, we are determined to ensure that the NHS Plan represents a step-change for the health service that is both affordable and deliverable. I am confident that the plan can and will be delivered within the set timescales.

§ Baroness Carnegy of Lour
My Lords, it has been suggested that what the British Medical Association has been saying is simply a spin designed to affect the pay review for doctors which is presently under way. Can 1he Minister confirm that, far from that being the case, the BMA gave detailed views as to its anxieties on the day the plan was announced—at the end of July—and that since then other bodies have confirmed very much the same view? I refer to the Royal College of General Practitioners, the National Health Service Alliance and the National Association of Primary Care. All those bodies have detailed anxieties. Will the Government pay attention to the views of general practitioners?

§ Lord Hunt of Kings Heath
My Lords, I suppose it depends on which Dr Bogle we are listening to. Is it the Dr Bogle to whom the noble Baroness refers, or is it the Dr Bogle who said on 7th September 2000: Overall, the NHS plan is an exceedingly good document. It shows a desire from Government, patients and those working in the health service to achieve the best health service in the world"? That was a fairly strong commendation of the NHS plan. Of course we will listen to what organisations such as the BMA have to say to us, but we are confident that the figures in the NHS Plan are robust. We see primary care as an integral part of the development of the plan. I am confident that the targets we have set of 2,000 extra GPs by 2004 will be met.

§ Lord Clement-Jones
My Lords, is not one of the ways of relieving pressure on GPs to allow much more nurse prescribing in primary care? The Government issued a paper in August but consultation is still going on. At a time when the Government are facing demands for more GPs, why are the Government dragging their heels in the area of nurse prescribing?

§ Lord Hunt of Kings Heath
My Lords, the Government are certainly not dragging their heels. Nurse prescribing has proved to be very important indeed. We are keen to develop it as soon as we can. I can assure the noble Lord that we will be bringing our conclusions to the House as soon as we possibly can.

§ Baroness Trumpington
My Lords, I heard what the Minister said about 2,000 extra GPs by 2004. Does he agree that that still puts us in the third division of world health systems? If he so wishes, I can refer to Greece, Germany and France. How does the noble Lord equate the figure of an extra 2,000 GPs with the plan's idea of a patient being able to see his GP within 48 hours, which I understand the BMA. says is totally unrealistic?

§ Lord Hunt of Kings Heath
My Lords, I do not agree with the noble Baroness. She may be referring to the number of doctors employed in each healthcare system. If she is, I would certainly acknowledge that this country has traditionally employed fewer doctors than many other healthcare systems. That is one of the reasons why we are committed to increasing the number of GPs and hospital consultants. But I would also say that in this country we have a very good record of using other staff, such as nurses, to do work that might be done in other healthcare systems by doctors. The noble Lord, Lord Clement-Jones, has already referred to the potential of nurse prescribing.
The noble Baroness referred to the 48-hour limit. Perhaps I may quote from Dr Adrian Attard, whose practice is participating in a primary care collaborative. The practice has cut its waiting times from five to six days to the Government's target time of 48 hours. Dr Attard said: We are not doing any extra surgeries and we are not working harder than before, we are just working in a different way". Many of the ways in which we can achieve the 48-hour limit will be by GPs working more effectively.

§ Lord Winston
My Lords, can my noble friend confirm that a number of senior members of the British Medical Association, having read the national plan, signed an endorsement of it before it was published, as did many major leaders in the healthcare professions? Does he not agree that the great majority of the medical professions welcome the national plan and intend to work with it?

§ Lord Hunt of Kings Heath
My Lords, there is no doubt about that. The 150 or so people who were involved in writing the NHS plan included many doctors. Many distinguished doctors signed up to the core values at the beginning of the NHS Plan. I can do no better than to quote from The Times, which is always to be believed in these matters. It quoted Sir George Alberti, President of the Royal College of Physicians, who urged Dr Bogle on 21st November to "stop belly-aching" and start innovating.