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Mr. Robert Jackson: That was a particularly difficult issue for my constituents at Shrivenham, who felt that the
appeal procedure was extremely remote and inaccessible and did not pay sufficient attention to them. Will the Minister comment on that?
Mr. Denham: The hon. Gentleman will understand that I am not familiar with that particular case. The system is designed to ensure, by virtue of the range of bodies and organisations consulted--including community health councils--that patients' views are adequately heard. If the hon. Gentleman would like to draw to my attention elements of his own local experience, perhaps by letter, I should be more than happy to look into the way in which the system operates. However, it would be going too far today to anticipate any possible changes.
In general, I must say that it is a great shame that disputes over dispensing rights too often become bitter and pit professionals against each other, when we want them to co-operate for the benefit of patients. I know that there are people who feel that disputes are in part caused by deficiencies in the existing regulations.
Pharmacists, for example, often say that they do not understand why the regulations can lead to GP practices in the centre of small towns operating a dispensary in competition--as they see it--with a nearby pharmacy. They point out that that pharmacy might even be located next door to the surgery. I am told that that is generally known as the market towns issue.
On the other hand, GPs have asked why different rules apply when a pharmacy already operating in a health authority's area applies to open a new branch in a rural area. In particular, they have asked why, in such cases, pharmacy applicants do not have to pass the so-called prejudice test.
I know of no evidence that suggests that the rules operate in a way that prevents patients from getting access to the medicines that they need. Indeed, the regulations are designed precisely to ensure that change is managed in a sensible way, without putting necessary services at risk. I agree, however, that it would be desirable if improvements could be made so that there are fewer disputes in future. Reducing the number of disputes can only be good news for patients.
However, the House will understand that, like many Ministers before me, I am reluctant to appear to intervene on one side or the other in the debate over the minute detail of rural dispensing rules. That reluctance stems from a fear of stirring up yet more wasteful dispute. I say "wasteful", because the long and sometimes bitter history of dispute between the professions over this issue can have done nothing to promote the climate of co-operation and collaboration that is necessary if primary care services are to deliver the best for their patients.
My predecessors have said to both professions that we will consider sympathetically any joint proposals that they bring to us for tidying up the regulations--provided, of course, that any changes proposed are in patients' best interests. I am happy to repeat that offer today.
Indeed, I believe that, over the past year or so, there have been increasingly encouraging signs that the leaders of the two professions are beginning to work more closely together on many issues. I am told that, in the East Norfolk health authority area, relations between the professions are generally close and fruitful. Members of both professions have been involved in the development of a successful local health care guide, as part of the
health authority's charter mark winning commitment to providing people with high-quality information about local NHS services.
Good relations between the professions are very much to be welcomed. Partnership is one of the four key themes in our vision for a new, modern and dependable national health service. It underpins excellence, efficiency and performance. We took office determined to get rid of the divisiveness of the old national health service and its internal market. Collaboration, not competition, is the key to improving patient care. By implementing our vision of the new national health service, we are breaking down barriers that artificially divide those who need to work together for the health and well-being of local communities.
The national health service, local authorities and local communities are now discussing the first health improvement programmes--real strategies for local health. Our programme will improve services throughout the country, for people living in rural areas as much as those in towns and cities. By the year 2000, everyone in England will have access to the NHS Direct 24-hour nurse
advice line. In hospital, all people with suspected cancer will be able to see a specialist within two weeks of their GPs deciding that they need to be seen urgently. That target will be achieved by April 1999 for suspected breast cancer, and by 2000 for other cancers.
We have backed up our ambitious programme with the biggest-ever increase in resources for the national health service--an average of 4.5 per cent. over the next three years. Our vision extends equally to community pharmacy. My right hon. Friend the Secretary of State for Health has said that he will be publishing a strategy document on ways of exploiting more fully the potential for community pharmacy to contribute to better care, close to people's homes.
That strategy document, like our entire vision for the national health service, will be about harnessing individuals' skills within a context of ever-greater co-operation and shared endeavour. That, surely, is where we should be focusing our energies. Division and dispute belong to the old NHS.
It being before Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.
Sitting suspended, pursuant to Standing Order No. 10 (Wednesday sittings), till half-past Two o'clock.
1. Mr. John Healey (Wentworth):
If he will make a statement on progress towards meeting the target of making 25 per cent. of government services available on-line by 2001. [68643]
The Parliamentary Secretary, Cabinet Office (Mr. Peter Kilfoyle):
We intend to publish information about departmental performance every six months, beginning in May 1999. Last year, we set a target for 25 per cent. of services to be electronically deliverable by 2002.
Mr. Healey:
I thank my hon. Friend for that answer and the encouraging news of future publication of departmental performance. Does he acknowledge that many services that people use are delivered by local government and local national health service facilities, rather than directly by central Government agencies? What targets have he and his ministerial colleagues agreed on the contribution that local government and the NHS can make to the achievement of on-line Government services?
Mr. Kilfoyle:
We are looking at targets at the moment. The next list will not be available until May, although we recognise in our target expectation that the vast majority of services are provided not by central Government agencies, but by local authorities and the NHS. The strategy for dealing with those will be published in the spring in the White Paper on better government.
2. Dr. Tony Wright (Cannock Chase):
When he expects to publish the White Paper on the modernisation of government. [68644]
6. Mr. Christopher Chope (Christchurch):
If he will report on progress in preparing the better government White Paper. [68649]
The Minister for the Cabinet Office (Dr. Jack Cunningham):
We will publish a White Paper in the spring, setting out our proposals for more strategic policy making and simpler, more effective and responsive public services.
Dr. Wright:
I am grateful to my right hon. Friend for that answer. Modernisation is the hallmark of this Government, and must apply to all government. That means that people should have access to public services that they find easy to use, that operate efficiently and
Dr. Cunningham:
Yes, I can. My hon. Friend is absolutely right. The three aims that he has mentioned will be the objectives of our White Paper.
Mr. Chope:
Is not the better government White Paper just another of this Government's public relations stunts? Are not public services declining? If that is not true, why have the Government just published a 60-page document entitled, "Public Relations Toolkit for Employers", which invites small businesses to give third-party endorsement to failed Government policies? How much did that document cost? When will the Government follow the advice given on page 17--it will interest you, Madam Speaker--to "Answer the question succinctly", and "don't be evasive"?
Dr. Cunningham:
After such a long, rambling and incoherent question, the hon. Gentleman is the last one to talk about stunts. He knows all about them. I have no doubt that all the users of the national health service, in which we intend to invest £21 billion extra, and all the users of the education service, in which we will invest £19 billion extra, will note his disparaging remarks about public services.
Ms Margaret Moran (Luton, South):
On the publication of the White Paper on modernisation of government, will my right hon. Friend ensure that we encourage service users to take the opportunities offered by new technology to provide regular feedback, so that we can measure the improving quality of public services? Such improvement is a clear objective of the Government, and one on which the previous Administration were a dire failure.
Dr. Cunningham:
I pay tribute to my hon. Friend's pioneering work in that connection when she was leader of Lewisham borough council. We shall set ourselves a target of delivering 25 per cent. of Government services through information technology by 2002. We want those services to be available not only easily but, where possible, 24 hours a day, seven days a week.
Sir Patrick Cormack (South Staffordshire):
I notice that, by grouping the questions, the right hon. Gentleman is equating modern with better, but is it either modern or better for a Government to treat a Select Committee of the House as disdainfully as the Government have in the past 24 hours? What place do parliamentary democracy and the work of our Select Committees have in the right hon. Gentleman's ideal of modern government?
Dr. Cunningham:
I have always, personally, had a very high regard for the Select Committees of the House. I was a member of a Select Committee of the House for six years, and in roughly one year as Minister of Agriculture, Fisheries and Food I agreed to appear before the Select Committee on Agriculture four times. My appearance on the fourth occasion was obviated by my appointment to my present responsibilities.
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