NHS: Five Year Forward View — Statement

Part of the debate – in the House of Lords at 11:55 am on 23rd October 2014.

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Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health 11:55 am, 23rd October 2014

My Lords, I am grateful to the noble Lord for his welcome of the report which I am sure is shared by all noble Lords. It is, as the Statement says, a very useful set of conclusions jointly reached by the leaders of our health service and their partners. The noble Lord is right to say that there are common areas of agreement between the Government’s view of how we should move forward in the NHS and the view of the Official Opposition. I refer in particular to the role of integration, not only integration between health and social care, but also between hospital care and out-of-hospital care and between public health and health services. The report endorses the direction of travel that the Government are already taking in initiatives such as the Better Care Fund.

I turn now to the noble Lord’s specific questions. On GPs, we are not of the same mind as regards making GPs salaried employees of the health service. The independent practitioner model has served the country well and we do not think that there is any appetite in the general practitioner community to move in the direction that the party opposite would like. However, I certainly agree that there is a powerful role for health and well-being boards to play, and in many areas they are already doing so by bringing together the key players in a local area to decide on the health priorities of that area and to work out the right strategies to meet them.

On public health, as the Five Year Forward View emphasises, obesity is one of our major public health challenges and will continue to be so. I do not agree that the responsibility deal has been inadequate. It is only a part of a menu of options which the Government have available. We have seen major advances resulting from the responsibility deal and we should not throw those away. It means bringing business along willingly with us: business with its power and reach which goes far beyond that of the Government to influence consumer behaviour.

On GP services, I agree that many GP practices are under strain, but our vision and, I am pleased to say, the vision in this report, really centres around remodelling primary care in the round so that GPs consider themselves part of a wider primary and community care team. Yes, we need more GPs, and we have undertaken to ensure that the NHS has at least 5,000 more by 2020, but more broadly we should look at the multidisciplinary mix of those teams and expand nurse numbers and allied health professional numbers to supplement the work that GPs do.

On parity of esteem, we shall have a useful Oral Question next week which will give us a short opportunity to debate it. As I am sure the noble Lord is aware, a lot of work is going on to make parity of esteem a reality, including for the very first time defining waiting times for mental health patients and ensuring that mental and physical health are looked at on a par by both commissioners and providers.