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My Lords, I too am grateful to the noble Lord, Lord Freyberg, for the excellent, comprehensive speech with which he opened this debate. After hearing my noble friend Lord Bethell, I am sure that many noble Lords will share my wish to hear much more from him in the future.
I draw your Lordships’ attention to a little-known success story of the initiative of GPs in England—the creation of two databases of notifications of their clinical work. These databases are SystmOne and EMIS. Input is mandatory for all primary practices in England. These databases are widely used across the medical profession, not only in primary care. They have been in operation for some 20 years and provide instant access to statistics on, for instance, cancer, diabetes and heart conditions. I am advised that the secret of their success is that the programmes were written by doctors. They are completely anonymous—this subject has been mentioned by several of your Lordships. Great steps are taken to make sure that the data input is anonymised. There is certainly nothing to match them among the acute hospital trusts and there is no other country in the world to match them in the comprehensiveness of the data which they store and make available for medical research in England and worldwide. My noble friend Lady Neville-Rolfe mentioned the excellent advances made in Australia, Singapore and other places. But I was told that in New Zealand—which prides itself on its primary care—there is no equivalent even there.
Here in the United Kingdom, practitioners act as gatekeepers. In many countries with admirable primary care—and, incidentally, which spend a greater proportion of GDP on it—a patient is referred at an early stage to a specialist in, say, cancer or diabetes. In England, the practice of triage enables the GP to assess the needs of the whole man—or comprehensive gender equivalent—and only then to refer him, or her, to the appropriate specialist.
These databases are a shining example of the contribution of general practitioners to primary care, which was so aptly described by Simon Stevens, chief executive of NHS England, as the jewel in the crown of the NHS.
Time does not permit me to go into greater length on this subject in this debate—except, possibly, to say that much more use should be made of general practices to relieve pressure on A&E departments. But that is for another day. These databases are a fine example of the use of healthcare data in the United Kingdom which, in so many ways, leads the world.