Primary Care

Oral Answers to Questions — Health – in the House of Commons at 11:30 am on 22nd July 2008.

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Photo of Lynne Jones Lynne Jones Labour, Birmingham, Selly Oak 11:30 am, 22nd July 2008

If he will make a statement on the implementation of the proposals in the NHS next stage review final report on equitable access to primary care.

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

Primary care trusts continue to make good progress in securing more than 100 new GP surgeries in under-doctored areas and 152 GP-led health centres, to be open to patients 12 hours a day, 365 days a year. Those services will improve access, extend choice and complement existing family doctor services.

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Photo of Lynne Jones Lynne Jones Labour, Birmingham, Selly Oak

According to a recent survey of people attending a mental health day centre in south Birmingham, 85 per cent. did not have a GP. That shocking result demonstrates the need to expand primary care services and fill the gaps, so the Government's increased investment is welcome. However, the confusion about the rules on expanding those services is not so welcome. Will my right hon. Friend take this opportunity to clear up the confusion by explaining the difference between giving money to existing GP practices to expand, which is apparently not allowed, and GP practices bidding to provide additional services, which is allowed?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

Yes, I am happy to do that. We are giving £100 million to all GP practices this year to improve the care that they offer patients. On under-doctored areas, we believe that there is a genuine need in the most deprived areas—the 25 per cent. of primary care trusts with the worst provision—to provide new services and new centres, not only for GP services, although they will be GP practices, but for the facilities to screen, and to deal with issues such as smoking cessation and all the problems that health inequality encapsulates. That is not to say that we are not also giving extra money to existing GP surgeries, but we believe that we need new services, some for the capacity reasons that my hon. Friend mentioned.

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Photo of Patrick Cormack Patrick Cormack Chair, Northern Ireland Affairs Committee, Chair, Northern Ireland Affairs Committee

Apart from taking a well-deserved holiday, will the Secretary of State spend some time during the recess considering the sort of letters that primary care trusts send to those to whom they have to decline grants or treatment? Some are grossly insensitive and written in the most insensitive, bureaucratic language. Will he have a look at that?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

I thank the hon. Gentleman for wishing me well on my holidays. I hope that on his holidays he will read the NHS constitution, which is out for consultation until 17 October. It includes a paragraph that relates precisely to the point that he makes. If a PCT decides that a drug that is outside the NICE process will not be approved, it should do that transparently. Under the constitution, patients will have a right to receive lucid and transparent information about the PCT's decision.

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Photo of Paddy Tipping Paddy Tipping Labour, Sherwood

But do a significant number of patients not want more flexibility about seeing their GP at weekends and in the evenings? In the 60th year of the NHS, should we not back the patients rather than the professionals?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

My hon. Friend is right. Incidentally, we now have the latest figures. Since concluding the agreement with the British Medical Association in April, in which we sought the extension of provision in the week and on Saturdays—we expect 50 per cent. of GP surgeries to offer that extended provision by the end of the year—we have already moved in the first couple of months to 28 per cent. coverage. That is what patients need, not least in the constituency of my hon. Friend Lynne Jones: in Birmingham recently, patients had a specific concern about access to GP surgeries.

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Photo of Sandra Gidley Sandra Gidley Shadow Minister, Health

Although the GP centres in under-doctored areas are welcome, does the Secretary of State agree that he has missed a trick on the GP-led health centres, which have been imposed on PCTs? If PCTs had a little more time, they could have consulted local communities and probably placed the GP-led health centres in areas where they were needed, and people would not feel quite so put upon.

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

I do not accept the hon. Lady's point. There is a genuine problem with capacity—we are not considering a zero-sum game. From next year, we want all men and women between the ages of 40 and 74 to come in on a call and recall basis under a vascular screening programme. When we announced that earlier this year, the BMA said it did not have the capacity. There is a genuine need for those services. Each PCT must consult on the new GP-led health centres, and they will be welcomed. As the Health Service Journal said of the Opposition a couple of weeks ago, it is easy to campaign against closures but it takes a perverse genius to campaign against openings.

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Photo of Geraldine Smith Geraldine Smith Labour, Morecambe and Lunesdale

Although the extra Government investment in GP services is most welcome, why is there not the flexibility to allow existing GP practices to expand to meet the need, rather than having to create a new practice, which could have the effect of destabilising existing GP services? That is a real concern to GPs in my constituency. This should be done in that way only if the primary care trust wants that, but the PCT in my area blames the Government; it says it would like to do it another way, but the Government will not allow it to do so. What is the true situation?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

My hon. Friend has raised this point with me, and a letter about the disgraceful attitude of the PCT is winging its way towards her. Although there may be numerous PCTs which are trying to duck this issue by blaming the Government, they are wrong. We are talking about the provision of care for their patients. My hon. Friend is talking about under-doctored areas, and they have been under-doctored for 60 years. If that was just a matter of handing over the money to the British Medical Association, which is what its political representatives on the Opposition Benches argue for, it would have been resolved years ago. We are saying that the new GP services are important for these areas as they are in the interests not only of patient care but of something I know my hon. Friend is passionate about: tackling health inequalities.

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Photo of Mark Simmonds Mark Simmonds Shadow Minister (Health)

We in this House all agree that there must be the highest standards of patient care, and the Darzi report rightly highlights the lack of accessible information about some GP practices, which hinders patient choice. However, this issue was identified in a previous Government report that was published two and a half years ago in January 2006, yet to date there has been minimal progress. Will the Secretary of State explain how patient care is to be improved, specifically via all-important innovation, when GPs do not have, and will not have, control of real budgets, the centralised target culture is to be maintained and extra tiers of regional bureaucracy are to be created via this report, instead of a responsive, patient-centric, outcome-based service?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

There is obviously an audition on the Opposition Front Bench. There will be a reshuffle soon by the Leader of the Opposition, and with Mr. Lansley away, this is the other shadow Ministers' chance to audition.

Let me unpick the question a little. The argument that Mark Simmonds uses is that GP practices somehow do not have any control over the situation. We negotiate with the BMA constantly. There are issues around improving patient care on which we agree with the BMA, and we are working closely with it to resolve them. The point about a bureaucracy emerging from the Darzi review is nonsense. The Darzi review takes into account the views of thousands of clinicians across the country, and it is about the opposite of this kind of bureaucracy. It says that with the right metrics—I apologise for using that dreadful term, but they use it—in place, quality can be measured and thus improved.

On central targets, I pointed out in the last debate we had on this issue that 16 years after the Conservatives came to power, their Secretary of State for Health was setting a target of waiting no longer than 18 months for important clinical treatment. The fact that that will be 18 weeks maximum by the end of this year is a tribute to the NHS, but a necessary part of achieving that was the introduction of those targets.

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