GP Fundholders

Oral Answers to Questions — Health – in the House of Commons at 12:00 am on 22nd March 1994.

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Photo of Mr Harry Barnes Mr Harry Barnes , North East Derbyshire 12:00 am, 22nd March 1994

To ask the Secretary of State for Health what research she has undertaken into the effect of GP fundholding on equal access to health care; and if she will make a statement.

Photo of Ian Taylor Ian Taylor , Esher

To ask the Secretary of State for Health what recent discussions she has had with GPs on the impact of fundholding.

Photo of Dr Brian Mawhinney Dr Brian Mawhinney Minister of State (Department of Health)

Ministers and officials regularly meet the British Medical Association and other organisations to discuss the successes of the national health service reforms, including GP fundholding.

Photo of Mr Harry Barnes Mr Harry Barnes , North East Derbyshire

Is the Minister aware that a BMA survey shows that 42 per cent. of acute units have special arrangements for GP fundholders? How does that relate to the question that was asked about equality between GP fundholders and GPs without that facility? Is not there a terrible injustice in the difference between the two categories?

Photo of Dr Brian Mawhinney Dr Brian Mawhinney Minister of State (Department of Health)

I am aware that, despite repeated requests for evidence of a two-tier system, no evidence has been forthcoming from the BMA, the Joint Consultants Committee or the Labour party. I am also aware that the BMA is in favour of continuing to work with the Government on GP fundholding. That will come as a great shock to the Labour party, which is committed to abolishing fundholding.

Photo of Ian Taylor Ian Taylor , Esher

Will my right hon. Friend acknowledge the fact that all GPs are effectively in the private sector, as self-employed people contracting with the national health service? It is not surprising, therefore, that they want to use the best techniques that they can to achieve efficiency savings on behalf of their patients. Will my right hon. Friend welcome the two new fundholding practices in my constituency, in Esher and Claygate, which are joining the existing fundholding practice in Horsley?

Photo of Dr Brian Mawhinney Dr Brian Mawhinney Minister of State (Department of Health)

My hon. Friend is absolutely right. I congratulate and welcome the two fundholding practices in his constituency. He will be interested to know that from 1 April the 20.3 per cent. of the population of the Kingston and Richmond family health services authority—of which his constituency is a part—that is covered by GP fundholders, will increase to 74.5 per cent. The House may also be interested to know that from 1 April there will be an extra 562 fundholding practices, 850 GP practices within those fundholders, and 2,740 GPs becoming fundholders. More than one third of the population of the country will then be covered by fundholding practices. That fact speaks louder than the weasel words of the Labour party.

Photo of Ms Liz Lynne Ms Liz Lynne , Rochdale

The Minister has mentioned the BMA report about so-called fast-tracking for GP fundholders' patients. Does not he agree that the report's conclusion is that a two-tier health service has been created? However much he denies it, he cannot get away from that fact. Will he tell us what he intends to do about that problem?

Photo of Dr Brian Mawhinney Dr Brian Mawhinney Minister of State (Department of Health)

I have an advantage over the hon. Lady in that it was to Ministers that the JCC produced its 35 examples of two-tierism last September. We examined every one of those examples and not one was found to be true. What is interesting about the latest BMA survey is that it is framed in such general terms that the BMA itself cannot substantiate the charge of two-tierism.

Photo of Mr Roger Sims Mr Roger Sims , Chislehurst

May I encourage my hon. Friend to continue vigorously to rebut allegations of two-tier care? Does he agree that both health authorities and fundholding GPs must work within budgets and although it is perfectly possible that the health authority may have completely allocated its budget while GP fundholders still have funds in hand, the reverse situation could equally arise?

Photo of Dr Brian Mawhinney Dr Brian Mawhinney Minister of State (Department of Health)

As is so often the case, my hon. Friend is precisely right. What is interesting about Labour Members is that they have got themselves caught up in structures when what the national health service is about is patients. The proof of the pudding is the fact that we are treating more patients in this country than ever before. The increase in the number of patients that we are treating is higher than before, the quality of the treatment is higher than before, the convenience of the treatment is better than before and GP fundholders are in the lead in virtually all those areas.

Photo of Hugh Bayley Hugh Bayley , City of York

The Minister has been able to provide me with information about the amount of money per patient that is allocated to fundholding doctors, but he says that he does not have information about the amount of money per patient that is allocated for the same services for patients of non-fundholding doctors. As he does not have the figures, how can he say that there is equal access when he cannot say that there is equal money for the two types of patients?

Photo of Dr Brian Mawhinney Dr Brian Mawhinney Minister of State (Department of Health)

The allocation of resources is done on a basis that is not only fair but seen and recognised as fair by everyone except Labour Members.