HC Deb 07 November 1989 vol 159 cc556-9W
33. Mr. Nellist

To ask the Secretary of State for Health what representations he has recently received concerning the effect on women of the proposals contained in the White Paper "Working for Patients"; and if he will make a statement.

Mrs. Virginia Bottomley

We have received a small number of representations. Our proposals will benefit women, as all patients, by bringing all parts of the NHS closer to the standards already achieved by the best.

38. Mr. William Powell

To ask the Secretary of State for Health how patients will be affected by the proposals in the White Paper "Working for Patients."

Mr. Kenneth Clarke

The point of all our proposals is to produce a better NHS providing the type and standard of service a patient has a right to expect throughout the country. Hospitals will have more freedom to manage their own affairs and so will be able to respond better and quicker to individual patients and their GPs. District health authorities for their part will in future be able to concentrate on identifying the health needs of the populations they serve and then making sure that they receive a comprehensive range of high quality services. They will be able to use contracts to specify the quality of services to be provided. Extra funding will go directly to hospitals which can best provide the services needed. This means that the hospitals to which most patients want to go will be funded accordingly.

Clinical audit will make sure that there is systematic quality control of treatments throughout the Health Service with, for the first time, all doctors looking critically at what they and their colleagues are doing so that they can improve their effectiveness and outcomes. Patients will have shorter waiting times and better appointment systems; 100 more consultants will be appointed in addition to the existing year-by-year growth in numbers. The new GP contract will result in improved services and some large GP practices will be able to seek to make more effective use of NHS funds for their patients.

The effect of all these, and the other proposals in the White Paper, will be to make the NHS more consumer conscious and better able to provide a high quality service.

42. Mr. Latham

To ask the Secretary of State for Health whether he will make a statement on his discussions with the British Medical Association regarding the White Paper "Working for Patients."

Mr. Kenneth Clarke

I had a useful meeting with the British Medical Association on 18 October. We both took away ideas for further consideration. I am always ready to enter into constructive discussions with the BMA about how best to implement the proposals in the White Paper.

49. Mr. Bellingham

To ask the Secretary of State for Health if he will make it his policy to ensure that the proposals in the National Health Service White Paper will not mean that patients will be compelled to travel long distances for treatment.

Mrs. Virginia Bottomley

No patient will be made to travel long distances for treatment against their will. Surveys have shown that a majority of patients are willing to travel to get earlier or better treatment. When doctors refer patients to hospital they will take the circumstances and wishes of patients fully into account.

51. Mr. Devlin

To ask the Secretary of State for Health if he will outline further improvements that patients can expect to result from the implementation of the White Paper "Working for Patients".

Mrs. Virginia Bottomley

There are a number of detailed proposals in the White Paper, "Working for Patients", which will lead to substantial improvement for patients when implemented. These include ensuring that patients are given reliable appointment times, better waiting and counselling facilities, much fuller information about the services available and about their own care and quicker notification of diagnostic test results. We are asking everyone working in the Health Service to recognise the importance of the individual patient. In future it will be easier to choose and, if necessary, change GP.

55. Mr. Roy Hughes

To ask the Secretary of State for Health what consultations he proposes to have with the British Medical Association, the Royal College of Nursing, the Confederation of Health Service Employees, the National Union of Public Employees and the National and Local Government Officers Association concerning the Government's White Paper "Working for Patients".

Mr. Kenneth Clarke

My fellow Ministers and I have had several meetings with representatives of all the trade unions mentioned about how best to implement the reforms set out in the White Paper.

57. Mr. David Nicholson

To ask the Secretary of State for Health if he will make a statement on progress towards implementing the proposals in the National Health Service White Paper.

Mr. Kenneth Clarke

We are making good progress in putting into action the changes outlined in the White Paper "Working for Patients". I am confident that the NHS will be ready to implement the basic elements of the new and better systems of matching growth and resources with expansion of patient services by April 1991 if Parliament approves the necessary legislation. We have made £82 million available to finance progress towards implementation this year.

We have issued detailed guidance on many subjects including the new contracting system for all district health authority hospitals and community units and on education and training for non-medical staff.

We have recently launched a project to support district health authorities in detailed work on developing the key role which DHA's will have under the new system of identifying and obtaining the best pattern of services which will most effectively meet all the health needs of the populations they serve.

We have received more than 180 expressions of interest from potential NHS hospital trusts; 79 of them are proceeding towards being in the first wave of applicants for self-governing status within the NHS in April 1991 and I expect many more to be ready for later waves of applicants in future years.

We are spending more than £1 million on the development of self-audit systems by the medical profession and a £4.5 million scheme has been launched to develop information technology skills. Demonstration projects, aimed at improving the quality of care and service to patients, have been announced for five out-patient departments. The principles of general management are being introduced into the family practitioner committee system.

Good progress is also being made in relation to medical education and research. As I explained in a speech on 10 July, since sent to all hospital doctors, I intend to take powers to ensure, for instance, the continuation of high standards of undergraduate, postgraduate and continuing medical education and research in all NHS hospitals. I will also ensure that postgraduate training posts are provided in NHS hospital trusts in accordance with the national objectives set out in "Achieving a Balance". Medical education and research will be further enhanced by the proposed increased in the service increment for teaching (SIFT) to meet 100 per cent. of the median excess costs of teaching hospitals. This will be distributed by regions in consultation with medical schools.

60. Mr. Moss

To ask the Secretary of State for Health if he will make a statement on the aims of the proposals affecting family practitioner committees in the White Paper "Working for Patients".

Mr. Kenneth Clarke

The proposals in the White Paper which directly affect family practitioner committees are designed to equip each committee to take on the major tasks of implementing in 1990 new contracts of service for medical and dental practitioners; of helping to introduce the reforms proposed in the White Paper "Working for Patients" which affect family doctors; and generally to manage and develop effectively all the primary health care services for which they are responsible in the light of the Government's proposals in the White Paper "Promoting Better Health".

76. Mr. Carttiss

To ask the Secretary of State for Health if he will make a statement on the implications for patient choice of the proposals in the White Paper "Working for Patients".

83. Mr. Gerald Bowden

To ask the Secretary of State for Health how patients' choice will be affected by the proposals in the White Paper "Working for Patients".

Mrs. Virginia Bottomley

Our proposals will help to ensure that patients are given reliable appointment times, better waiting and counselling facilities, much fuller information about the services available and about their own care and quicker notification of diagnostic test results. We are asking everyone working in the Health Service to recognise the importance of the individual patient.