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Scanners

7. Dr. Brian Iddon (Bolton, South-East) (Lab): How many additional scanners have been provided in the NHS in the last year; and how many of these are in the north-west. [182187]

The Secretary of State for Health (Dr. John Reid): Forty-five scanners—29 CT and 16 MRI scanners—were delivered to the NHS through centrally funded programmes in 2003–04. Of those, six were delivered to NHS trusts in the north-west. In addition, we announced last week that NHS MRI scanning capacity will be increased by a further 15 per cent. as a result of procuring 12 state-of-the-art mobile units from the private sector. Three of those will be based in the north-west.

Dr. Iddon: I welcome that news. The New Opportunities Fund has provided the Royal Bolton hospital with a new £700,000 scanner, which will detect cancers. Unfortunately, it is being used only for six half-day sessions a week because the hospital cannot provide suitably trained staff who can interpret the images from the scanner. What account is my right hon. Friend taking of the budgets necessary to staff the new scanners? Can he please comment on the provision of adequately trained staff?

Dr. Reid: In terms of the budgets, even our most churlish critic would accept that an increase in the Bolton Hospitals NHS Trust budget from about £108 million to £130 million between 1999 and this year is a significant increase in revenue funding. As to the scanners themselves, my hon. Friend will be aware that one MRI scanner was delivered last year and I believe that two CT scanners are scheduled to be delivered in the next couple of years. In terms of staff, yes, it is
 
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difficult. We are expanding NHS staff and 84 per cent. of them are involved in direct patient care, despite the constant refrain from Conservative Members that everyone in the NHS is a useless unproductive bureaucrat. It is difficult to get radiologists, but I can tell my hon. Friend that there are more radiology staff than ever before. Since 1997, the number of clinical radiologists has increased by 26 per cent. and the number of diagnostic radiographers by 13 per cent. We will boost those figures further by an additional £3 million investment.

Mr. Nigel Evans (Ribble Valley) (Con): The Secretary of State for Health has mentioned mobile scanners. Will he ensure that they will be made available to rural areas around the north-west of England, including Clitheroe in Ribble Valley, whose needs are as great as in any other place? Will he also ensure that trained staff will be made available to local residents so that they secure the level of service that they are paying for?

Dr. Reid: We are certainly trying to do that. The point of having mobile scanners is not just to add to capacity, although the announcement last week by the Minister of State, Department of Health, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton) spoke of adding some 500,000 to 600,000 scans to our capacity over the next few years, which is an enormous increase. The fact that they are mobile means that they can be taken to the places where the needs are greatest and also to rural areas. There will be two mobile units in London, two in north-east Yorkshire and Humber, three in the north-west and west midlands, two in the east midlands and the east and three in the south. That, to adopt the word of the morning, is cause to celebrate, not least in Leicester where two MRI scanners have already been delivered and Birmingham where three MRI scanners and nine CT scanners have been delivered.

General Practitioners

8. Tony Lloyd (Manchester Central) (Lab): What initiatives are in place to encourage the retention of general practitioners in inner-city areas. [182188]

The Minister of State, Department of Health (Mr. John Hutton): The Government are committed to increasing the number of GPs working in under-doctored areas, which include many inner-city practices. A range of measures have been put in place to achieve that, including the allocation of extra training places and payments of up to £12,000 for GPs beginning their careers in those areas.

Tony Lloyd: Obviously, my right hon. Friend's answer is very helpful, but may I draw his attention to the specific problem of population change in the inner cities? There has been a very rapid decline in some areas, and in others—such as the centre of my city of Manchester—the increase has been extremely rapid. A decline in population places a significant strain on GPs in financial terms, while a rise poses difficulties in terms of patient numbers. I hope that my right hon. Friend looks very seriously at the problem. The rapid population growth in the centre of Manchester is a major issue. We need more GP services to serve the new
 
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population. The problem is not unique to Manchester but is apparent in other cities, such as Birmingham and Leicester, where the Government's many achievements are already celebrated. However, people are listening to the debate on this matter.

Mr. Hutton: I very strongly agree with my hon. Friend. Central Manchester's population is booming because of the significant success of local regeneration schemes. I agree too that there is a need to ensure that primary care trust funding allocations keep abreast of population changes. I accept his criticism that that may not always have happened in the past. That is why we are looking very carefully at the problem that he highlights as part of the next wave of allocations to PCTs, and I am sure that he will agree that it is a priority.

Mr. Jonathan Sayeed (Mid-Bedfordshire) (Con): The Minister will know that GP retirements are concentrated in inner-city practices run by a single doctor—and especially in practices where the retired doctor was Asian. The Government have promised some 2,000 more GPs, but have not specified that they will all work full-time. The British Medical Association says that we need an extra 10,000 GPs. How do the Government intend to square that circle?

Mr. Hutton: I hope that the hon. Gentleman at least will welcome the fact that 2,000 more GPs are working in the NHS—but perhaps he was coming to that. There has been a significant increase in the number of whole-time equivalents as well. We need to continue the investment and to support PCTs in using a variety of mechanisms to expand the GP work force. The hon. Gentleman's strictures today would have had more credibility if he and his party had any plans to increase the size of the primary care work force. Sadly, they do not.

Mr. Bill O'Brien (Normanton) (Lab): On the question of retaining GPs in inner-city areas, will my right hon. Friend take into consideration the problems that arise in urban areas? When two GPs left a practice in my constituency, the withdrawal of the satellite service caused much inconvenience for people. Is there any incentive to encourage doctors to work in urban areas? The PCT has done all it can to fill the vacancies, but more assistance is needed.

Mr. Hutton: Again, I agree with my hon. Friend that there remain parts of primary care in England that experience difficulties in recruiting more GPs, and he referred to problems in his area. In my earlier answer, I set out some of the incentives that we have put in place, but I can tell the House that we are looking at ways to increase them further. I hope to make an announcement on that very shortly.

9. Miss Anne McIntosh (Vale of York) (Con): If he will make a statement on the implementation of the new general practitioner contract. [182190]

The Minister of State, Department of Health (Mr. John Hutton): The new primary care contract was approved overwhelmingly by a ballot of general
 
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practitioners, and is being implemented successfully. All but five practices working under general medical services arrangements have signed the contract. Payments under the new contract have all been made on time.

Miss McIntosh: People can see a doctor within 48 hours only if they declare themselves to be an emergency, and in parts of the country it is impossible to see a doctor out of hours in the evenings or at weekends. Will the Minister apologise for that? Does he accept that the new GP contract is an abject failure, and that his Government have let this country down?

Mr. Hutton: No. In the light of recent exchanges in the House, I hope that the hon. Lady will understand why I will not take at face value any of the so-called facts that she has just brought to our attention. They are not the case. She might be better off having a word with the motley crew on the Opposition Front Bench about the new GP contract, because I understand that the hon. Member for South Cambridgeshire (Mr. Lansley) has said that he supports it.

Mr. Bob Blizzard (Waveney) (Lab): Lowestoft is not a city like Manchester, Birmingham or Leicester, but it contains some of the deprivation associated with those cities. In assessing the new GP contract, will my right hon. Friend take into account the difficulties of recruiting and retaining GPs in the poorer parts of Lowestoft, which do not benefit from the incentives that are offered elsewhere? Will my right hon. Friend look at that situation?

Mr. Hutton: Yes, I certainly will look at the point that my hon. Friend raises. The incentives for new GPs who are starting their careers are all targeted at under-doctored areas, and that will include the constituency that my hon. Friend so ably represents. The key is to continue the investment in primary care, which is set to increase by 33 per cent. over the next couple of years and to ensure that we seek to improve the health of the poorest communities in Britain at a faster rate than any other community. That is what this Labour Government are committed to doing.

Mr. Simon Burns (West Chelmsford) (Con): Does the Minister really think it is successful that last weekend in Norfolk half the GPs who provided the out-of-hours service had to be flown in from Germany? Is the Minister doing anything to prevent the inevitable chaos at weekends for the out-of-hours service as GPs cease to have surgeries on Saturday mornings, and the pressures on the service in the evenings during the week as patients cannot get appointments?

Mr. Hutton: I know that the hon. Gentleman has a vested interest in spreading doom and gloom about the national health service. In relation to the points that he raises, some 40 PCTs have now successfully negotiated opt-out arrangements in relation to the new contract with their local practices. The general view is that those opt-out arrangements are working effectively. The hon. Gentleman raised the issue of Norfolk and I understand that it is looking at finding some doctors from Germany to support the work of GPs.
 
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It was important to make the changes to the contract, because the doctors themselves asked us to do it and agreed to the changes in the ballot. The new contract will help us in the wider sense of recruiting more GPs to work in primary care. However, we should nail one misunderstanding. The contract does not suggest that out-of-hours services will end: it will remain the case that people will have access to a GP out of hours. That is the legal responsibility of PCTs and it cannot be avoided. My understanding is that the Conservative party supports the changes to the contractual arrangements for the employment of GPs, but they come here and imply that they think that we should not make those changes. What a bunch of hypocrites they are. [Hon. Members: "Oh!"]

Mr. Speaker: Order. The right hon. Gentleman will withdraw that remark.

Mr. Hutton: Of course, Mr. Speaker—

Mr. Speaker: Order. He should say nothing else; just withdraw the remark.

Mr. Hutton: I am happy to withdraw that remark.

Ms Gisela Stuart (Birmingham, Edgbaston) (Lab): GP services in Birmingham have improved tremendously and the contracts are working. It is a fact that 98 per cent. of people in Birmingham can see a GP within 48 hours. However, GPs do not operate in isolation. We must continue to drive down the waiting lists for referrals to see a consultant. Will my right hon. Friend remind the people of Birmingham—especially those in Hodge Hill, who will be voting soon—which party represents their interests, is driving the NHS forward and will continue those improvements, not jeopardise them?

Mr. Hutton: I am very happy to do that. People face a clear choice between a party that is committed to investment and giving patients guarantees about when they will be treated and by whom, and the Opposition, who would do none of those things.

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