Our plans are set out in the recently published White Paper "Promoting Better Health". Major changes are to be made in the system of payment to doctors to encourage them to provide a range of health promotion and preventive activities; for example, the introduction of incentive payments for reaching target levels of population cover for vaccination, immunisation and cancer screening and new payments for arranging and providing regular health promotion sessions for patients. The family doctors' contract with the National Health Service will be amended to make health promotion and the prevention of disease a specific part of their terms of service.
I appreciate my hon. Friend's comment. The first negotiating meeting with the General Medical Services Committee will take place this week on 14 January. We will discuss details with the profession. We hope to provide incentives for doctors to reach targets, as I have said, and we will pay a fee to encourage doctors to provide an initial clinical assessment for patients registering for the first time with an NHS doctor. We will also introduce sessional fees for doctors who run health promotion clinics. In addition, we will seek to negotiate the payment of the basic practice allowances depending on a doctor carrying out health promotion and prevention of ill-health activities.
While I welcome the Minister's statement about screening, will he accept that restricting free eye-testing will hinder detection, as optometrists detect what ophthalmologists diagnose, and that it will cost the Health Service more in the long run to end the free eye test?
I do not accept that any of our evidence suggests that in the long run charges deter people from seeking treatment. I hope the hon. Gentleman recognises what we are seeking to achieve in addition to the very substantial increases in moneys going into primary health care. That will enable us to increase resources, especially for inner city and rural areas.
As regular check-ups are so much a part of private medicine, may I assume from the words "health promotion" that my right hon. Friend is now extending that service to the National Health Service so that the "fit person" medical will become part and parcel of the health of this country?
My hon. Friend is right. We are trying to ensure that we are as concerned with the promotion of good health as with simply eradicating sickness. To that extent, my hon. Friend will watch with interest, as I will, our negotiations with the medical profession to see that contracts reflect that.
Is it not a fact that among the many causes of ill health have been the increases in unemployment, increases in homelessness and the abolition of nutritional standards for school meals? Is it not absolute hypocrisy for the Government to say that they are concerned about preventive medicine when they have allowed all those things to grow under their jurisdiction? Is it not the simple truth that the Government are making the country sick?
Most rational people who try to approach the health of the nation with a sense of rationality and balance will understand the political hypocrisy behind that question. Happily, the reality is that, under most Governments since the second world war, our nation has over the past 40-plus years seen a pattern of health improvement. We are now trying to supplement that by adding to the promotion of good health and the prevention of ill-health.
Did my right hon. Friend carry out, before issuing his White Paper on primary health care, as accurate as possible an assessment of the extra loading that will fall on family practitioner committees if they are to have to process the immense number of item-of-service claims? What financial provision will be made to enable them to fulfil their function?
My hon. Friend has made an excellent point. Within the White Paper, which is aimed at promoting health, we are seeking to add to the responsibilities of the family practitioner committees. To that extent we are committed to giving, through negotiation, additional resources to those committees that will allow them to carry out increased duties.