What assistance his Department has given to the review of out-of-hours doctors' services in Northumberland carried out by the Northumbria Healthcare NHS Trust and the Northumberland primary care trust.
As the right hon. Gentleman will be aware, I made my views on this matter known in the Adjournment debate that took place in January. A review has since taken place, and it is right and proper for the local health trust to take action on the recommendations, as it is now doing.
In thanking the Minister for her interest, may I ask her to put the weight of her Department behind the recommendations of the review team, particularly to ensure that doctors working in community hospitals 50 miles from the general hospital are suitably trained, and that cross-border arrangements are used to help to provide a stronger service in Berwick and other new arrangements in Alnwick? In particular, will she look again at the reasons why Northumberland is not getting rural money designed to help with situations just such as this, given that it is about the most rural and thinly populated part of England?
The right hon. Gentleman is aware that funding goes to the strategic health authorities and, across the strategic health authority, it does not qualify for rural funding. But, as I am sure he knows, money is not the issue in regard to the out-of-hours service. I agree that the trust now needs to take forward the recommendations that address the points that he has made about training and access. I think that that will address the issues that we have been trying to deal with, and I think that the right hon. Gentleman also believes that to be the case.
It is all very well for the Minister to push this matter back on to the local primary care trust, but one of the problems is the new general practitioners' contract, under which many GPs in Northumberland do not work on Saturdays. The consequence is that the Northern Doctors Urgent Care service gets nearly 1,000 calls on a Saturday, which is overwhelming the service. Doctors are travelling 70 or 80 miles to answer calls in rural Northumberland because of the pressure on the business. Surely the Minister should revisit the GP contract.
Eighty per cent. of GPs supported the new contract. The hon. Gentleman will also be aware that there were already arrangements in place under which large numbers of GPs delegated their responsibilities to co-op arrangements, so very little has changed in that regard—it is just that responsibility can now be passed back to the primary care trust. That has huge advantages for addressing service fragmentation and getting a better service. Indeed, in areas such as Cheshire, a much better service is now being provided. I trust that areas in which there are issues will look at the areas in which there is good practice, so as to develop the same best practice and to provide patients with the best possible out-of-hours service in all areas.