---

General Practitioners

9. Mr. Bill O'Brien (Normanton) (Lab): What advice is given to primary care trusts to assist with recruitment of general practitioners; and if he will make a statement. [169831]

The Minister of State, Department of Health (Mr. John Hutton): The Government have established work force confederations to take forward local recruitment initiatives to expand the national health service. In addition, we have invested more than £38 million in financial incentives to support flexible and new ways of working to encourage doctors to enter, and return to, general practice. As a result, the NHS now has more GPs than at any time in its history.

Mr. O'Brien: I thank my right hon. Friend for that reply. I congratulate the Government on the increase in nurses, doctors and consultants, more of whom are now employed by the NHS than ever before. My concerns are that in the north of England, and particularly in the
 
4 May 2004 : Column 1202
 
Wakefield area, we seem to have shortages of GPs, which affects a substantial number of my constituents. From my exchange of correspondence with the chairman of the Wakefield West PCT, it appears that it has little influence in trying to engage GPs to fill vacancies. Can my right hon. Friend give any further advice to ensure that my constituents, particularly the elderly and disabled, have GPs, and to ensure that the requirement for GPs in the Wakefield area is met?

Mr. Hutton: I am grateful to my hon. Friend for acknowledging the progress that has been made. In Wakefield, there are now 27 more GPs than there were in 1997. I accept entirely his view that there are still not enough. Clearly, we look initially to primary care trusts to fill those vacancies, and a range of resources is available to help them to do that. As he knows, we are making more progress in making sure that every primary care trust has its fair share of resources, and that the extra growth available for the NHS goes to those parts of the service that need it the most. That would certainly include my hon. Friend's constituency.

Mr. Paul Burstow (Sutton and Cheam) (LD): The Minister will know of the important role played by GPs in community hospitals up and down the country. Given that, will he offer some assurance about the current state of play with GPs who are already opting out of working in community hospitals, or who plan to do so in the near future? Health Ministers in the Welsh Assembly and the Scottish Parliament have recognised the disaster that that would represent and have started negotiations about the problem, so why does it appear that he still has his head in the sand?

Mr. Hutton: On this occasion, I hope that I do not have my head in the sand. The hon. Gentleman should remind himself of the recommendations of the doctors and dentists review body this year, which suggested that we should take this forward as part of the review of the non-consultant career grade for doctors in the NHS. We are happy to do that. Those issues are being discussed with the British Medical Association as we speak. Obviously, we also need to take the view of the NHS Confederation, which from this October will become the new employers' organisation for the NHS. Clearly, it is important that we make sure that services are provided to community hospitals by GPs. The new GP contract has nothing whatever to do that, as those arrangements are dealt with separately, and I hope that we will be able to make an announcement on that in the very near future.

Mr. David Watts (St. Helens, North) (Lab): The Minister will know that it is most difficult to recruit and retain GPs in some of the poorer areas. Is there not a case for add-in incentives to persuade them to come to and stay in very deprived areas?

Mr. Hutton: There certainly is. That is why—as my hon. Friend, who takes a close interest in these matters, will be aware—we have increased the golden hello scheme payments for GPs in areas with too few doctors from £10,000 to £12,000. The increase has partly succeeded, in that it has enabled us to recruit more GPs, but, as my hon. Friend will know, we are looking
 
4 May 2004 : Column 1203
 
carefully at all the issues. I have received representations from a number of my hon. Friends about GP shortages in their constituencies. Along with the NHS, we are trying to find ways of providing further incentives. As my hon. Friend rightly observed, general practice is at the heart of all our NHS reforms.

Mr. Tim Yeo (South Suffolk) (Con): Will the Minister confirm that Government claims to have met the GP recruitment target are complete and utter nonsense? Is it any wonder that no one believes a word Ministers say, now that they have been caught blatantly distorting the true picture by ignoring the difference between full-time and part-time GPs?

Will the Minister confirm that the number of long-term GP vacancies is now rising alarmingly? Will he also confirm that as the country faces an incipient crisis with the retirement of large numbers of GPs in the next three years, it is a disgrace that the Government's only answer is to try to fiddle the figures?

Mr. Hutton: I was wondering when we would hear from the hon. Gentleman. Unfortunately, I do not think that any of us would have minded too much if he had spent the half-hour session just nodding quietly to himself—[Interruption.] Was that the best that he could do? He is trying to carve out more space for himself and other Front Benchers by recognising improvements in the NHS when they happen; but where was that today? May we hear one word from him acknowledging that there are 2,000 more GPs in the NHS today than there were in 1999?

The hon. Gentleman says that we are fiddling the figures. We collect the figures for the number of GPs in exactly the same way as they were recorded in 1997 under his party's Administration. He should be careful about chucking around allegations that the figures are not correct. They are collected by the Office for National Statistics, and if he thinks that the ONS is fiddling the figures he should raise the matter with the National Statistician rather than chucking around pathetic and totally unfounded allegations about their accuracy.

David Taylor (North-West Leicestershire) (Lab/Co-op): Are not GPs more likely to be recruited if practices are well funded and well housed and offer a wide range of services? How often do we see the situation described to me in recent weeks by practices in North-West Leicestershire? Following the implementation of the general medical services contract, a number of doctors have been unable to offer minor injury and other non-core services because the funding for primary care trusts and the prices that they are offering are not enough to pay for such facilities. What guidance is given to PCTs about minimum levels of off-contract funding? What happens if the levels are very low?

Mr. Hutton: We have introduced a number of reforms to the way in which primary care is funded. I suspect that those local difficulties are partly connected with arguments about the definition of the new class of enhanced services under the GMS contract, and I hope that they can be resolved.

It should be borne in mind that the new contract will be accompanied by a 33 per cent. increase in spending for primary care, which I am sure my hon. Friend will
 
4 May 2004 : Column 1204
 
welcome. First and foremost, however, disputes need to be resolved at local level. I do not think it would be very sensible for me to try to intervene in each one, but I assure all my hon. Friends that the new contract is being fully and properly resourced. We have introduced important reforms that will help to ensure that the additional money we have earmarked for primary care is spent on improving GP services.

Waiting Lists (Romford)

10. Andrew Rosindell (Romford) (Con): If he will make a statement on waiting lists in Romford. [169832]

The Minister of State, Department of Health (Ms Rosie Winterton): The main acute hospital providing health services for residents of Romford is Barking, Havering and Redbridge NHS trust. The trust is currently achieving both the elective admission and first out-patient appointment waiting time targets.

Mr. Rosindell: I do not think my constituents will be convinced by that response. I have countless examples of people from Romford who have been waiting for months, if not years, for essential operations. What does the Minister say to senior citizens in my constituency, who worked hard, paid their taxes, expect a health service now that they are older and feel utterly betrayed and let down by the Government?

Ms Winterton: No doubt the hon. Gentleman will be keen to let his constituents know that the number of patients waiting for elective surgery in Barking and Havering health authority in March 1997 was 10,077 and that the number of patients waiting in Havering PCT in February this year was 5,268. That is a difference of about 50 per cent. Those figures speak for themselves.

Angela Watkinson (Upminster) (Con): When the new Oldchurch hospital was planned, a series of specialist GP practices throughout the area was also planned, to be developed concurrently. The purpose was to relieve pressure on the new hospital and to shorten waiting times. The hospital is due to open in 2005, but to date it has not been possible for the primary care trust to develop one single specialist GP practice. What assistance can the Minister offer to the primary care trust to enable it to meet its deadline?

Ms Winterton: As the hon. Lady knows, under the policy of shifting the balance of power, decisions on local provision of services rest at local level. Obviously, if she wishes to raise a particular problem, she can write to us about that with notice and we will respond to it accordingly.

---