NHS Reform (Hansard, 25 July 1989)

§ 14. Mr. Rathbone
To ask the Secretary of State for Health what special allowance he has made in his plans for National Health Service reforms to ensure proper general practitioner services for small town hospitals.

§ Mr. Kenneth Clarke
On 4 May I agreed with the GMSC negotiators that where GPs were providing a necessary service in the public sector, such as being a clinical assistant in a small hospital, they would be required by their terms of service to be available to their practice's patients on a minimum of four, rather than five days a week. This will ensure sufficient flexibility to allow GPs to continue their contracts with local hospitals.

§ 25. Mr. David Harris
To ask the Secretary of State for Health how the proposals in the White Paper, "Working for Patients", will affect general practitioners' freedom to refer patients for treatment.

§ 82. Mr. Hague
To ask the Secretary of State for Health how general practitioners' ability to refer patients for treatment will be affected by the proposed reform of the National Health Service.
658W

§ Mr. Kenneth Clarke
When district health authorities place contracts, they will be expected to give effect to the referral patterns which local GPs want. They will need to consult closely with their GPs, therefore, in order to agree a range of contracts which make best use of their resources to secure the best services for their residents. As a result, local GPs will be much more closely involved in planning health care for their patients than at present. GPs will also have their freedom to refer increased, because for the first time they will be able to refer patients for NHS treatment in private hospitals. DHAs will be much better placed to take advantage of GPs' knowledge of their patients' needs.
GP practice budget holders will of course have their freedom to refer increased because they will be able to negotiate their own preferred pattern of referral with hospitals and units using the taxpayers money at their disposal.

§ 31. Mr. Arbuthnot
To ask the Secretary of State for Health what progress is being made on the implementation of the proposals in the White Paper, "Working for Patients".

§ Mr. Mellor
We are pleased to be able to say that good progress is being made on the implementation of our proposals for the Health Service. Consultation is taking place with a great many interested parties, including those 659W representing medical opinion, and we are working with NHS managers to ensure smooth implementation. Progress includes: receipt of 178 expressions of interest in self-governance from hospitals and other NHS services; publication of an initial guide on self-governing hospitals which has provided much more information about how self governing hospitals will operate; the establishment of the new NHS management executive and the NHS policy board; a major initiative to improve the quality of service is now under way; publication of a further working paper on the capital charging system; the first 56 hospitals are now in the process of installing new information systems; shortlisting for 90 FPC general manager posts is virtually complete and a number of appointments have already been made. medical audit systems are being developed at a cost of £2 million this year; and bids for the 100 extra consultant posts promised in the White Paper are due at the end of July.

§ 40. Mr. Stevens
To ask the Secretary of State for Health how education and training will be affected by the proposals in the White Paper, "Working for Patients".

§ 54. Mr. Carrington
To ask the Secretary of State for Health what are the implications of the White Paper, "Working for Patients", for education and training.

§ Mr. Mellor
Since the White Paper "Working for Patients" was published, a number of working papers have been issued and these contain some further detail about training and education. The working paper, "Self-Governing Hospitals—An Initial Guide", advises that a consultation paper on training and education will be issued shortly, which will deal fully with these important issues.

§ 65. Mr. Pawsey
To ask the Secretary of State for Health what representations he has received directly from members of the public about the reforms of the National Health Service.

§ Mr. Mellor
We have received more than 5,000 representations directly from members of the public in respect of our proposals for the Health Service.