HL Deb 21 October 2003 vol 653 cc1496-8

2.52 p.m.

Lord Campbell of Croy

asked Her Majesty's Government:

Whether they favour the recording and publication of tables of general practitioners' performance in their work in the medical profession.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)

My Lords, after 1 st January 2005, the Freedom of Information Act will provide the public with a general right of access to information held by public authorities, including the information held by primary care trusts relating to the work of GPs. We will consult key stakeholders, including the British Medical Association, about the arrangements for doing that to ensure that the rights of patients and practitioners under the Data Protection Act are safeguarded.

Lord Campbell of Croy

My Lords, I thank the noble Lord for that reply. While performance tables are being compiled in some areas, does he agree that although such tables promote friendly competition, they do not everywhere provide choice for patients because there is a national shortage of general practitioners?

Lord Warner

My Lords, there may be a misunderstanding. The issue arises out of the arrangements under the new contract in relation to a quality and outcomes framework, which was agreed by the profession—the profession wanted it. That will show how well GPs are treating patients with 10 common chronic illnesses. It is a method of paying GPs, not for compiling league tables.

Lord Clement-Jones

My Lords, in all the publicity, contrary to what the Minister said, the official tables show that GP vacancies are up by 800 this year and that total GP vacancies are now at 3,500. Is it not grossly misleading for the Government to give the public the impression that they can judge quality in a GP when they cannot even get access to one?

Lord Warner

My Lords, the noble Lord has been joining us in our midnight—and later—activities on the Health and Social Care (Community Health and Standards) Bill. He will know that that Bill will implement a number of major improvements, which have been agreed by the profession. They will provide an even higher quality of primary care service than we currently have.

Lord Roberts of Conwy

My Lords, can the Minister offer any explanation of the fact that GP vacancies are up by one-third to, I believe, 3,435 and that deprived urban areas are particularly badly affected?

Lord Warner

My Lords, I did not think that this Question was about deprived areas and GP practices. We are addressing the problems around GP supply. There has been an increase in the number of GPs under this Government. There are some longstanding problems in particular areas and the new contract will improve the quality of primary care widely across the country.

Lord Colwyn

My Lords, if details of GP performance are recorded and published as tables, how can we be reassured that they contain an accurate reflection of performance rather than a view of patient health, which varies enormously across the country and which is intrinsically linked to patient poverty?

Lord Warner

My Lords, the noble Lord is quite right—any information about performance by any health professional does not necessarily indicate that the health of the general population in that area is improving; wider issues, apart from healthcare, affect the population's health in any particular area.

Earl Howe

My Lords, was the specific idea of GP league tables discussed with GP representative bodies prior to the Government's announcement?

Lord Warner

My Lords, I must try to nail this issue. The idea is getting abroad because there is a proposal, which has been agreed by the profession in the new contract, for a quality and outcomes framework, which will enable GPs to be paid on the basis of the quality of the services that they provide. Incidentally that information will tell one something about the point score under the framework that a particular GP attained in order to get the payment that he deserves as a result of that work. We are merely saying that under the Freedom of Information Act, it is possible that that information could be available to the public. They will have that right under the Freedom of Information Act after 1st January 2005. We will be discussing with the BMA how that information might be made available publicly while safeguarding the rights of practitioners and patients under the Data Protection Act.

Lord Walton of Detchant

My Lords, at a time when, as several noble Lords have said, there is a national shortage of general practitioners and when, in the next two years, all doctors will have to cope with a programme of professional appraisal under the rules that are being introduced by the General Medical Council, will the Minister see to it that the process will not be too administratively burdensome on general practitioners?

Lord Warner

My Lords, the noble Lord makes a perfectly fair point. I remind the House that the contract was agreed by the BMA and that, in a ballot of GPs and with a turnout of 70 per cent, 79 per cent voted to accept the contract. The Government are not forcing a contract on GPs; the Government and the NHS Confederation are working with the profession to agree a new contract. From what I have said, I am sure that it is clear that we will exercise care in relation to the way in which information is made available under the Freedom of Information Act.