HL Deb 25 June 2001 vol 626 cc121-4

2.49 p.m.

Lord Campbell of Croy

asked Her Majesty's Government:

What arrangements they are making to conclude new contracts with general practitioners working in the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)

My Lords, the NHS Plan commits us to introducing a new and modernised GP contract by 2004. The General Practitioners Committee of the British Medical Association shares this aim and would prefer to achieve the change earlier. We are happy to work with the committee to try to secure this outcome.

Lord Campbell of Croy

My Lords, I thank the noble Lord for that reply. Is he aware that, in the recent ballot of GPs held by the BMA asking whether practitioners would resign if acceptable changes in their contracts were not made, some 56 per cent of all the GPs in Great Britain responded by saying "Yes"? An officer of the BMA has commented that this demonstrates the depth of GPs' disillusionment. Does the noble Lord agree that these doctors are under intense pressure? Will the Government seek urgently to improve their situation?

Lord Hunt of Kings Heath

My Lords, we are certainly prepared to meet with the BMA at an early stage to discuss the negotiations over a new contract. I agree that GPs are under considerable pressure. They are the front line of NHS services. Primary care is a major load. We must do everything we can to ensure that GPs and their staff are able to meet the growing pressures upon them. That is why the Government have increased the number of medical education places. We want more people working as general practitioners, and that is why we will invest a considerable amount of money in improving the facilities and premises of GPs and encourage GPs to look at ways of improving their working practices.

Lord Walton of Detchant

My Lords, does the Minister agree that worsening morale among general practitioners within the National Health Service has led to an unusually large number of them seeking early retirement from the NHS? In the light of those findings, does he accept that the matter of a new contract is—as the noble Lord, Lord Campbell of Croy, said—of great urgency? By the Government's own admission, 10,000 additional GPs are needed to provide a proper standard of primary care within the NHS. What action are the Government taking to retain doctors and to recruit new general practitioners?

Lord Hunt of Kings Heath

My Lords, I agree that we must do everything we can to recruit more GPs, for example, through the increase in the number of medical training places that we have established and through retaining GPs for as long as they wish to work within the National Health Service. The noble Lord will know that we have announced a number of incentive schemes designed to encourage GPs to not retire early but to stay with the NHS for as long as possible. Through a combination of measures—increasing the number of GPs, increasing the number of other primary care staff working with GPs and ensuring that the facilities in which they work are of a high quality—together with negotiations over the new contract, I am confident that we will increase the number of working GPs and increase their morale.

Lord Clement-Jones

My Lords, I congratulate the Minister on his return to the health hot seat, which may become hotter over the next few years. As to the question raised by the noble Lord, Lord Walton of Detchant, on the issue of the recruitment of doctors to general practice, in the general election the Government promised an additional 2,000 general practitioners over the next four years. However, the BMA estimates the number required to be 10,000. There is a big disparity between those two figures. Will the Minister undertake to review, as a matter of urgency, the numbers required to enter general practice in order to ease the workload on general practitioners, which is one of the key problems?

Lord Hunt of Kings Heath

My Lords, I thank the noble Lord for the welcome he gave to my continuation in post. Perhaps I may reciprocate: I hope that he, too, retains his position in opposition on the Liberal Democrat Front Bench. I should make it clear that the 2,000 figure is a floor—in other words, it is the minimum we want to achieve. Of course we would like to have even more GPs working for the National Health Service. A primary care workforce review is in being at the moment. As a result, I hope that we will see many more people coming to work within the primary care field.

Lord Marsh

My Lords, does the noble Lord agree that if GPs retire in this way, almost certainly a high proportion of them will go into the private sector? Would it not be a good place to start a joint NHS/private sector experiment in the GP field?

Lord Hunt of Kings Heath

No, my Lords, I do not. G P services will always be a core National Health Service provision. That is what the public and the Government want. We are pursuing the right path by ensuring that the new contract rewards quality and outcome of treatment as much as quantity of treatment; by ensuring that we increase the number of GPs; by ensuring that their working conditions are improved; and, by increasing the numbers of other members of the primary care team, ensuring that we give GPs the confidence to remain with the National Health Service. The negotiations with the GPC are clearly crucial and we are committed to early meetings with the BMA on the issue.

Baroness Uddin

My Lords, can my noble friend tell the House whether these consultations will include patient representatives? Can he further say what is the timeframe for concluding the negotiations?

Lord Hunt of Kings Heath

My Lords, we have set no timeframe for concluding the consultations. Under the NHS Plan we wish to see implementation by 2004. So far as concerns the voices of patients' representatives, it is a consistent feature of this Government's approach to the NHS that we seek the views of patient groups and other organisations representing the public at both national and local level.

Baroness Gardner of Parkes

My Lords, can the Minister tell the House what effect NHS Direct has had? We were told that it would take quite a burden off general practitioners. Has it done so, or has it added to their burden?

Lord Hunt of Kings Heath

My Lords, the interim reports that we have received from the evaluation of NHS Direct show that it has been associated with halting an upward trend in the demand for out-of-hours general practice. In a number of areas, local GPs have asked NHS Direct to act as the first point of contact for patients seeking, for instance, medical help out of hours. In addition, pilot schemes in one or two parts of the country have encouraged the public, when ringing NHS Direct, to go for advice to their local pharmacist where that is appropriate. Community pharmacists have an enormously enhanced role to play in giving advice to the public where appropriate. I am sure that that is one way in which we can relieve the load on general practitioners.