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General Practitioners

10. Tim Loughton (East Worthing and Shoreham): If he will publish whole-time equivalent target figures for additional GPs in service by 2004. [3773]

The Minister of State, Department of Health (Mr. John Hutton): The NHS plan commits us to providing at least 2,000 more general practitioners by 2004. The number of whole-time equivalent GPs resulting from that increase will clearly depend on a number of factors, but we expect that the overwhelming majority will be full-time.

Tim Loughton: Using the phrase "will clearly depend" is not the same as saying that there will be 2,000 doctors. Is it not now patently clear that all the Secretary of State's and the Prime Minister's much trumpeted claims about new doctor and nurse recruitment do not bear close scrutiny? It later transpired that of the 2,000 extra GPs promised in the next four years more than half were in the pipeline already. Is it not the reality that, as the British Medical Association has made patently clear, whole-time equivalent GP numbers are static and that many experienced doctors are still leaving the NHS or are set to leave or retire early, when we can ill afford to lose them? If the Secretary of State or the Minister cannot guarantee that promising 2,000 extra doctors will actually mean that there will be 2,000 extra, how can we take their pledges on nurse recruitment or any of their other election promises seriously?

Mr. Hutton: There will be 2,000 extra GPs, and we have made that very clear. The hon. Gentleman's arguments lack both consistency and credibility. On consistency, it is worth pointing out to the Conservatives that they cut the number of GPs in training by 20 per cent. between 1991 and 1996. Had the number been maintained at its 1991 level, there would be nearly 700 more GPs in practice today and 1,000 more by 2004. It is not terribly flattering to the hon. Gentleman to pretend that he is committed to a policy when his record in Government shows that he took the opposite approach.

In addition, the hon. Gentleman criticises us for lack of ambition in recruiting GPs. The Tory manifesto for the last election contained no pledge to increase the number of GPs in the national health service: not a single GP was

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promised. We are determined to reverse the trend that we inherited and are increasing the number of GPs as well as the number of full-time equivalent GPs in the NHS.

Judy Mallaber (Amber Valley): I have been visiting GP practices in my constituency in recent weeks and have seen improved services such as counselling and smoking cessation. Will my right hon. Friend assess the impact of the new primary medical services system and the appointment of nurse practitioners and other clinicians in enabling practices and GPs to operate more efficiently and flexibly? Will he also reconsider the NHS information systems to ensure that there is proper and easy access to the information that is required by GPs and PCTs?

Mr. Hutton: Overall, the introduction of PMS has had a hugely beneficial impact on the delivery of primary care services. We intend to continue those initiatives to ensure that GPs and their patients have the greatest access to choice. PMS has allowed us to make sure that we can provide primary care services in some of the most underprivileged and deprived parts of Britain. That is an important step forward.

My hon. Friend is also right about information services for GPs and primary care practice. It is important that we improve those for the benefit of not only GPs but their patients. That is why we are embarking on a major investment in information technology upgrading across the NHS, which will benefit many people.

Derek Conway (Old Bexley and Sidcup): Is the Minister aware that recruiting additional GPs will prove difficult in my constituency because the Bexley primary care trust is just under £8 million short of its capitation weighting? Will he address that problem? Although it may be comfortable for him to live in the past, he has been in office for a while and it is time that he took responsibility for the shortfall that is affecting our areas.

Mr. Hutton: I am sure that the hon. Gentleman wants more money spent on the NHS. So do we, but we are providing the extra resources, unlike the Conservatives who clearly would not have been able to. He knows that we are reviewing the formula that determines how resources are distributed across the NHS. That has not been completed, but I hope that it will be shortly. I hope that he will be able to endorse and support one change—the emphasis that we are placing on the role of primary care trusts as the main conduits through which resources reach the front line of the NHS. It is better for the NHS for those to be as close to the front line as possible. I am sure that that will benefit his constituents and all patients in Bexley.


11. Jane Griffiths (Reading, East): If he will make it his policy to recognise endometriosis as a long-term cyclical condition. [3774]

The Minister of State, Department of Health (Jacqui Smith): Endometriosis is a serious condition that can affect the lives of many women and their families throughout their reproductive years. The symptoms of endometriosis and their effect on individual women vary

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greatly. There are, however, acknowledged treatments and surgical procedures for this condition that can help very many women.

Jane Griffiths: I thank my hon. Friend for that reply which will be welcomed by many of my constituents and, indeed, the many thousands of women around the country who suffer from endometriosis. Can she assure me that steps will be taken to improve and speed up diagnosis? Many women first present with symptoms in their teens, and it may be 10 years until they are finally diagnosed and receive appropriate treatment.

Jacqui Smith: My hon. Friend is right to suggest that we need to ensure greater awareness of endometriosis. The NHS plan gives us the opportunity to improve, for example, the training of GPs and gynaecologists. The Under-Secretary of State, my hon. Friend the Member for Pontefract and Castleford (Yvette Cooper), had a useful meeting with the National Endometriosis Society, and officials are due to meet the society again this week. It is funded partly by the Department of Health's grant programme, and we are very willing to offer advice and assistance on how to raise awareness of the problem. In addition, the NHS plan will allow us to ensure that GPs and gynaecologists are in the best possible position to provide the treatment that women clearly deserve.

Out-patient Appointments

12. Dr. Jenny Tonge (Richmond Park): What plans he has to reduce the number of patients who fail to keep out-patient appointments. [3775]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): As part of the NHS plan, all out-patient appointments will be pre-booked by the end of 2005. Patients will be able to choose well in advance a date and time that is convenient to them.

Dr. Tonge: I thank the Minister for that response. I trust that the trusts that will have to implement the system will receive the finance due to them so that they can do so, and that the Government will be reporting on progress in achieving the targets that they have set themselves. Does the Minister think that, given continuing long waits to see, for example, a consultant or a radiologist in the first place, more should be done to convince patients who miss appointments that they are wasting NHS time and money and making the wait for their fellow patients much longer?

Ms Blears: Yes, the hon. Lady is right to say that more steps need to be taken to convince people about the cost to the service. Many hospitals now publicise such costs so that patients are aware of them. Many also telephone to remind people of their appointments, which often results in tremendous reductions in the number of appointments that are not kept. We are doing what works.

There will be more investment. There is an outline business case for a new electronic system to ensure that all out-patient appointments can be booked in advance. The very best way of getting patients to attend is to involve them in their treatment—for example, so that they feel ownership of their appointment—and to make

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appointments that are convenient for them, for their child care and for their looking after the rest of the family. That is the way forward.

Mr. Barry Sheerman (Huddersfield): Is my hon. Friend making excuses for patients? I recently visited a Leeds teaching hospital and was told by the receptionist that 40 per cent. of people with appointments on that day did not show. That is a disgrace and a misuse of the health service. Surely we do not need electronic devices. A simple deposit could be paid to be returned when one showed for one's appointment. Could not we return to some basic common sense in the health service?

Ms Blears: There is clear evidence that electronic booking systems are working. At Sandwell hospital, the percentage of patients who do not appear has fallen from 6 to 1 per cent; in north-west London, the figure has fallen from 13 to 6 per cent; and in Birmingham, the percentage of appointments that patients failed to keep has fallen from 20 to 5 per cent. as a result of electronic booking. As usual, what this Government do is what works.

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