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GP Contracts

10. Mrs. Cheryl Gillan (Chesham and Amersham): When he expects the new GP contract to come into force. [116533]

13. Mr. Andrew Lansley (South Cambridgeshire): If he will make a statement on the contract for GPs. [116536]

The Minister of State, Department of Health (Mr. John Hutton): The general practitioners committee of the BMA is currently balloting GPs on the new general medical services contract. Subject to approval and the passage of the necessary legislation, we hope to begin implementation of the new contract next year. The new contract will bring significant benefits to both doctors and NHS patients, by rewarding improvements in care and by widening the available range of primary care-based services. The new contract will also mean that expenditure on primary care will rise from £6.1 billion this year to £8 billion by 2006.

Mrs. Gillan: I thank the Minister for that answer, but will he admit to the House that negotiations on the GP contract have been a complete and utter shambles? Last year, 66 per cent. of GPs threatened to resign if a new contract was not negotiated successfully, and the Minister was able to ensure that the BMA would ballot members only by inserting a minimum practice guarantee. How long will that guarantee be in place, and who will decide when it is no longer necessary?

Mr. Hutton: No, the negotiations have not been a shambles. The contract was negotiated by two parties, the BMA and the NHS Confederation. The result has been a good deal for GPs and for NHS patients. I hope that the hon. Lady will join me in urging GPs to endorse the contract, because of the significant benefits that it will bring. We have made it clear that there will be no time limit on the minimum practice guarantee. It is not part of the new arrangements that any practice should lose out financially. Quite the opposite: there are significant financial benefits for GPs, and reciprocal benefits for patients. The hon. Lady should exhibit her usual good grace and welcome what is an important development for primary care, in her constituency and in the NHS as a whole.

Mr. Lansley : The Minister will know that the ballot result is expected on 20 June, and that the Standing Committee considering the Health and Social Care Bill will conclude proceedings on 19 June. If he intends to use the Bill as a vehicle for primary legislation to

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implement the contract, will he extend the time available in Committee, so that the provisions can be scrutinised by a Committee of this House, rather than only in another place?

Mr. Hutton: I wish that it was in my gift to extend the time available for consideration in Committee, but it is not. The Bill has to be reported by 19 June. With the best will in the world, there are some things that I cannot do, and unfortunately turning back time is one of them. I wish that I could do so. Given that the House has decided that the Bill must come out of Committee on 19 June, and that the ballot result will not be in until 23 June, in fact, our only opportunity to debate the measures and table amendments will come when the Bill returns on Report. That is what we intend to do.

Mr. Peter Pike (Burnley): Will my right hon. Friend accept that some GPs in Burnley believe that they need better premises to take full advantage of the new contract and to offer the full range of primary care treatment, as the Government intend? Does he accept that there is a shortage of funds, and that some GPs are being told that they will have to wait five or six years before they can offer that range of treatment? Will he perhaps meet me to discuss the possibility that additional money might be made available to get the contract accepted and to meet the Government's treatment requirements?

Mr. Hutton: I am grateful to my hon. Friend and I will certainly look into the situation in Burnley that he described. However, I echo the point made earlier by my hon. Friend the Minister of State: because of the additional investment that we are making available to the NHS, the primary care estate—the building blocks in primary care—will receive an additional £1 billion of investment over the next few years. That will help to transform many GP surgeries up and down the country. I agree with my hon. Friend—if that is what his GPs are saying—that if we want to provide the best possible quality primary care services, we must provide the best possible primary care buildings, and that is precisely what the Government are doing.

Chris Grayling (Epsom and Ewell): The Minister will be aware that he has already been accused by GPs of meddling in the negotiations over the proposed contracts and that his intervention at the time of the emergency conference in May was reported to have swung a crucial vote against the negotiating teams, so now that the ballot is actually going ahead, will he confirm whether he is planning to intervene again to impose the contract unilaterally if the vote goes against?

Mr. Hutton: The hon. Gentleman has waited 55 minutes to ask what is probably the most puerile question that we have heard from the Opposition Front Bench. I made no such interventions. He should not believe everything that he reads in the press, for heaven's sake.

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Hospital Service Providers

11. Mr. Jim Cousins (Newcastle upon Tyne, Central): What steps he is taking to speed up financial flows in the NHS to hospital service providers. [116534]

The Secretary of State for Health (Mr. Alan Milburn): As my hon. Friend is aware, local primary care trusts now control 75 per cent. of the total NHS budget. In deciding where to spend that resource, it is important that PCTs do so in partnership with local hospitals and strategic health authorities. To that end, local negotiations over this year's budgets in most parts of the country are now complete.

Mr. Cousins : I am grateful to my right hon. Friend for that answer, but he will of course understand that specialist hospitals, such as those in the north-east in Newcastle and Sunderland and on Teesside, may have dealings with up to 20 primary care organisations, some of which are quite slow in paying, with resulting problems; and that every improvement in those specialist services may have to be signed up to by up to 20 of those primary care organisations, with all sorts of slowing down of innovation and improvement. What can he say to hospitals in that position, which want to move on and to be sure that the money for service improvements is there?

Mr. Milburn: My hon. Friend is well aware, not least from his own close working relationship with the health service in Newcastle, that specialist hospital trusts, such as the Freeman and the Royal Victoria Infirmary in Newcastle, provide a range of services, which are, as he rightly says, not just district general hospital services, but more specialist tertiary services as well. Inevitably, therefore, those hospitals are in negotiation with a number of primary care trusts. In such situations, what normally happens is that one local PCT has the responsibility of becoming the lead commissioner and acts on behalf of a number of local PCTs. If that is not happening in my hon. Friend's area, I shall gladly look into the matter. He might also like to be aware that the NHS bank will shortly be conducting a review of how money flows around the system, precisely to ensure, first, that it gets to the front line, and secondly, that it does so in a timely way that does not jeopardise the provision of front-line patient services.

Mr. Henry Bellingham (North-West Norfolk): Does the Secretary of State agree that one of the keys to speeding up financial flows is the balance between management and front-line staff? Can he confirm his Department's figures showing that the number of qualified nurses in the NHS is 266,170? Is it true that, for the first time, that number has been overtaken by the 269,080 managers and support staff?

Mr. Milburn: I think that the hon. Gentleman is trying to count as managers and bureaucrats people in professions such as painters, decorators, gardeners and cleaners. With the best will in the world, not even he could believe that those people are bureaucrats.

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Health Care Assistants

12. Mr. Alistair Carmichael (Orkney and Shetland): If he will make a statement on the regulation of health care assistants. [116535]

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): The Government are committed to consult on proposals to regulate support workers, and that consultation will be taking place in the near future. The consultation will identify those categories of staff whose clinical practice needs to be of a high standard in order to ensure patient safety. The proposals cover a range of options, including full statutory regulation of those staff, and the Government will decide on the way forward in the light of responses to the consultation.

Mr. Carmichael : I thank the Minister for that answer, but I view the lack of urgency with which the Government are approaching the question as quite disappointing. Does he not accept that the increased use of such assistants without proper regulation exposes patients to risk and assistants to exploitation?

Mr. Lammy: Regulation of health care workers in Scotland is a matter for the devolved Parliament, but generally, we will be making proposals. It is right that we think carefully about them when other issues, such as "Agenda for Change", are continuing in the rest of the United Kingdom.

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