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The Minister of State, Department of Health (Ms Rosie Winterton): Opposition Members have asserted that the Government have failed to support family doctors. However, as the Minister of State, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), ably demonstrated in response to the hon. Member for South Cambridgeshire (Mr. Lansley), the exact opposite is true. Support for NHS general practice has never been greater.
There has been an unprecedented increase in investment in primary care under this Government. Expenditure will have risen by £6.8 billion in England by next year and by £8 billion in the UK as a whole. We have fostered innovation, with a greater range of services being offered to patients. We have increased the importance of primary care in the NHS and we have improved the rewards for NHS workers in primary care, both financially and in terms of professional responsibility.
The hon. Member for Southend, West (Mr. Amess) said that we were bashing doctors, but since July 2000, almost 2,500 general practice surgeries have been replaced or refurbished as we modernise the NHS infrastructure after years of under-investment. There are already some 1,300 GPs with special interests who are delivering a range of extended services in local settings that are convenient to patients. There are 1,169 more general practitioners than in 1997, and 3,280 more practice nurses. Record numbers of doctors are training to be GPs—almost 80 per cent. more than in 1997. We have introduced the new contract for GPs—unlike the previous Administration who imposed one—, which will considerably improve their quality of life and increase recruitment and retention. That is hardly bashing doctors.
The proof that our policies are working is the fact that more doctors are joining the NHS and staying within the NHS. They recognise that Labour is offering them a professional career in which they can concentrate on providing the best patient care. We are seeing an NHS that is becoming more local, not less. It is an NHS in which general practitioners and nurses have a greater say on how their patients are treated, and an NHS that is tailored to the needs of individual patients.
Let me briefly deal with several points made by hon. Members. I welcome the fact that the hon. Member for Sutton and Cheam (Mr. Burstow) acknowledged that there was extra investment in the NHS and that the new pharmacy contract presented an exciting opportunity to extend the role of pharmacists. He asked about GP vacancy rates. The vacancy rate in 2003 was 3.4 per cent., but that had reduced to 3 per cent. in 2004. The rest of his speech, however, was frankly a typical Lib-Dem whinge.
My hon. Friend the Member for Leigh (Andy Burnham) presented the vision of high-quality services that his constituency wants. He pointed out the
11 Nov 2004 : Column 990
importance of linking high-quality premises so that some of the GP vacancy problems that he was experiencing could be overcome. He talked about the way in which the LIFT scheme in his constituency was giving easier access to services. It was a great pleasure to visit his constituency and see how local people are working to improve services. He asked about funding, which we know that we need to address in some areas. He knows that we are considering allocations at the moment.
The hon. Member for New Forest, West (Mr. Swayne) gave a graphic description of his complaints about Primecare. We launched new guidelines on 14 October, which set out quality requirements for out-of-hours services, and I hope that those are useful in the meeting with his primary care trust.
My hon. Friend the Member for Newcastle upon Tyne, North (Mr. Henderson) referred to the difficulty in his constituency with the location of GPs in a particular area. The PCT can establish services under PMS where there is the greatest patient need. That may be a solution. However, I shall raise his specific point with the strategic health authority. My hon. Friend the Member for Luton, North (Mr. Hopkins) talked about the new health centres and walk-in centres in his constituency. He rightly drew attention to the importance of training and the provision of mental health services.
The hon. Member for South Norfolk (Mr. Bacon) raised the issue of IT. Of course we will listen to GPs' concerns. I also understand that my right hon. Friend the Minister of State has written to him about his specific points. If those are not dealt with in his correspondence, we will follow that up.
The hon. Member for Westbury (Dr. Murrison) mentioned Saturday morning services. PCTs can commission them as a matter of local discretion. Saturday morning surgeries are covered by out-of-hours services, as agreed in the new contract.
The Opposition motion says that we are failing to support family doctor services. The debate has demonstrated that nothing could be further from the truth or the reality of what is happening on the ground. The Conservatives had their chance to run the NHS. We know what happened when they were in control. Nurse training places were cut by 25 per cent. and GP training places were cut by 20 per cent. The fact is that under the Labour Government the NHS is getting better. We have record investment, 100,000 more doctors and nurses, the largest ever hospital building and equipment programme, better working conditions for all NHS staff and better treatment for NHS patients. Labour will keep the NHS free at the point of need. The increased investment that we are providing benefits the many, not the few. In our NHS, access is based on clinical need, not on how much people can afford.
The Conservatives have consistently voted against increased investment in the NHS. They voted against the increase in national insurance contributions to fund the health service. This Government will never remove £1.2 billion from the NHS to subsidise the well-off few who pay to go private. That is exactly what the Tories' patient's passport would do. The vast majority of Britain's hard-working families cannot afford £9,000 for a heart
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bypass operation or £5,000 for a hip replacement, and they would face the prospect of unlimited waits under the Conservatives.
The Government believe that primary care is the cornerstone of the NHS and we are committed to supporting it. NHS primary care consistently scores 90 per cent. in patient satisfaction surveys. That is not the achievement of an unsupported service. It is a fantastic tribute to the hard work and dedication of GPs and NHS primary care staff. It shows that the public support the NHS, and so do the Government. I urge the House to reject the Opposition motion and support the Government's amendment.
Question put, That the original words stand part of the Question:—
The House divided: Ayes 118, Noes 286.
AYES
Ainsworth, Peter (E Surrey)
Amess, David
Arbuthnot, rh James
Atkinson, David (Bour'mth E)
Atkinson, Peter (Hexham)
Bacon, Richard
Barker, Gregory
Baron, John (Billericay)
Beggs, Roy (E Antrim)
Bellingham, Henry
Bercow, John
Beresford, Sir Paul
Boswell, Tim
Bottomley, rh Virginia (SW Surrey)
Brazier, Julian
Browning, Mrs Angela
Burnside, David
Burt, Alistair
Butterfill, Sir John
Cameron, David
Cash, William
Chapman, Sir Sydney (Chipping Barnet)
Chope, Christopher
Clarke, rh Kenneth (Rushcliffe)
Clifton-Brown, Geoffrey
Collins, Tim
Conway, Derek
Cormack, Sir Patrick
Cran, James (Beverley)
Davies, Quentin (Grantham & Stamford)
Djanogly, Jonathan
Fallon, Michael
Field, Mark (Cities of London & Westminster)
Forth, rh Eric
Francois, Mark
Gale, Roger (N Thanet)
Garnier, Edward
Gibb, Nick (Bognor Regis)
Goodman, Paul
Gray, James (N Wilts)
Grayling, Chris
Green, Damian (Ashford)
Greenway, John
Grieve, Dominic
Gummer, rh John
Hammond, Philip
Hawkins, Nick
Hayes, John (S Holland)
Heald, Oliver
Heathcoat-Amory, rh David
Hendry, Charles
Hoban, Mark (Fareham)
Hogg, rh Douglas
Horam, John (Orpington)
Howarth, Gerald (Aldershot)
Jack, rh Michael
Jackson, Robert (Wantage)
Key, Robert (Salisbury)
Kirkbride, Miss Julie
Laing, Mrs Eleanor
Lait, Mrs Jacqui
Lansley, Andrew
Leigh, Edward
Letwin, rh Oliver
Lewis, Dr. Julian (New Forest E)
Liddell-Grainger, Ian
Lidington, David
Lilley, rh Peter
Loughton, Tim
Luff, Peter (M-Worcs)
McIntosh, Miss Anne
Maclean, rh David
McLoughlin, Patrick
Malins, Humfrey
Mates, Michael
Mawhinney, rh Sir Brian
Mercer, Patrick
Moss, Malcolm
Murrison, Dr. Andrew
Osborne, George (Tatton)
Ottaway, Richard
Page, Richard
Paisley, Rev. Ian
Paterson, Owen
Prisk, Mark (Hertford)
Randall, John
Robathan, Andrew
Robertson, Hugh (Faversham & M-Kent)
Roe, Dame Marion
Rosindell, Andrew
Ruffley, David
Sayeed, Jonathan
Shepherd, Richard
Simpson, Keith (M-Norfolk)
Smyth, Rev. Martin (Belfast S)
Soames, Nicholas
Spelman, Mrs Caroline
Spicer, Sir Michael
Spink, Bob (Castle Point)
Steen, Anthony
Swayne, Desmond
Syms, Robert
Tapsell, Sir Peter
Taylor, Ian (Esher)
Taylor, John (Solihull)
Taylor, Sir Teddy
Turner, Andrew (Isle of Wight)
Tyrie, Andrew
Walter, Robert
Waterson, Nigel
Watkinson, Angela
Whittingdale, John
Wilkinson, John
Willetts, David
Wilshire, David
Winterton, Ann (Congleton)
Winterton, Sir Nicholas (Macclesfield)
Young, rh Sir George
Tellers for the Ayes:
Mr. Hugo Swire and
Andrew Selous
NOES
Abbott, Ms Diane
Ainger, Nick
Ainsworth, Bob (Cov'try NE)
Alexander, Douglas
Allan, Richard
Allen, Graham
Armstrong, rh Ms Hilary
Atkins, Charlotte
Austin, John
Baird, Vera
Banks, Tony
Barnes, Harry
Barron, rh Kevin
Battle, rh John
Bayley, Hugh
Beard, Nigel
Beckett, rh Margaret
Benton, Joe (Bootle)
Berry, Roger
Best, Harold
Blears, Ms Hazel
Blizzard, Bob
Boateng, rh Paul
Bradley, Peter (The Wrekin)
Bradshaw, Ben
Brake, Tom (Carshalton)
Brennan, Kevin
Brooke, Mrs Annette L.
Brown, rh Nicholas (Newcastle E Wallsend)
Bryant, Chris
Buck, Ms Karen
Burgon, Colin
Burnham, Andy
Burstow, Paul
Byrne, Liam (B'ham Hodge H)
Cable, Dr. Vincent
Caborn, rh Richard
Cairns, David
Calton, Mrs Patsy
Campbell, Alan (Tynemouth)
Campbell, Ronnie (Blyth V)
Caplin, Ivor
Casale, Roger
Caton, Martin
Cawsey, Ian (Brigg)
Challen, Colin
Chapman, Ben (Wirral S)
Chaytor, David
Clapham, Michael
Clark, Dr. Lynda (Edinburgh Pentlands)
Clarke, rh Tom (Coatbridge & Chryston)
Clarke, Tony (Northampton S)
Coaker, Vernon
Coffey, Ms Ann
Cohen, Harry
Colman, Tony
Connarty, Michael
Corbyn, Jeremy
Cotter, Brian
Cranston, Ross
Crausby, David
Cruddas, Jon
Cryer, John (Hornchurch)
Cummings, John
Cunningham, Jim (Coventry S)
Darling, rh Alistair
Davey, Valerie (Bristol W)
David, Wayne
Davies, Geraint (Croydon C)
Dawson, Hilton
Dean, Mrs Janet
Denham, rh John
Dhanda, Parmjit
Dismore, Andrew
Dobson, rh Frank
Donohoe, Brian H.
Doran, Frank
Dowd, Jim (Lewisham W)
Drew, David (Stroud)
Drown, Ms Julia
Dunwoody, Mrs Gwyneth
Eagle, Angela (Wallasey)
Eagle, Maria (L'pool Garston)
Edwards, Huw
Efford, Clive
Ennis, Jeff (Barnsley E)
Etherington, Bill
Farrelly, Paul
Field, rh Frank (Birkenhead)
Fisher, Mark
Flynn, Paul (Newport W)
Follett, Barbara
Foster, Don (Bath)
Foster, Michael (Worcester)
Foster, Michael Jabez (Hastings & Rye)
Gapes, Mike (Ilford S)
George, Andrew (St. Ives)
George, rh Bruce (Walsall S)
Gerrard, Neil
Gibson, Dr. Ian
Gidley, Sandra
Gill, Parmjit Singh
Gilroy, Linda
Godsiff, Roger
Green, Matthew (Ludlow)
Griffiths, Win (Bridgend)
Hall, Mike (Weaver Vale)
Hall, Patrick (Bedford)
Hamilton, David (Midlothian)
Hancock, Mike
Hanson, David
Harris, Dr. Evan (Oxford W & Abingdon)
Havard, Dai (Merthyr Tydfil & Rhymney)
Healey, John
Henderson, Doug (Newcastle N)
Henderson, Ivan (Harwich)
Hendrick, Mark
Hepburn, Stephen
Heppell, John
Hewitt, rh Ms Patricia
Heyes, David
Hinchliffe, David
Hoey, Kate (Vauxhall)
Hood, Jimmy (Clydesdale)
Hopkins, Kelvin
Howarth, rh Alan (Newport E)
Howarth, George (Knowsley N & Sefton E)
Hughes, Beverley (Stretford & Urmston)
Hughes, Kevin (Doncaster N)
Humble, Mrs Joan
Hurst, Alan (Braintree)
Hutton, rh John
Iddon, Dr. Brian
Irranca-Davies, Huw
Jackson, Helen (Hillsborough)
Jamieson, David
Jenkins, Brian
Johnson, rh Alan (Hull W)
Johnson, Miss Melanie (Welwyn Hatfield)
Jones, Helen (Warrington N)
Jones, Jon Owen (Cardiff C)
Jones, Kevan (N Durham)
Jones, Lynne (Selly Oak)
Jones, Martyn (Clwyd S)
Joyce, Eric (Falkirk W)
Keeble, Ms Sally
Keetch, Paul
Kelly, Ruth (Bolton W)
Kemp, Fraser
Kennedy, rh Charles (Ross Skye & Inverness)
Khabra, Piara S.
Kidney, David
Kilfoyle, Peter
King, Andy (Rugby)
King, Ms Oona (Bethnal Green & Bow)
Ladyman, Dr. Stephen
Lamb, Norman
Lammy, David
Laws, David (Yeovil)
Lazarowicz, Mark
Lepper, David
Leslie, Christopher
Levitt, Tom (High Peak)
Lewis, Terry (Worsley)
Linton, Martin
Love, Andrew
Lyons, John (Strathkelvin)
McAvoy, Thomas
McCabe, Stephen
McCafferty, Chris
McDonagh, Siobhain
MacDonald, Calum
MacDougall, John
McIsaac, Shona
McKenna, Rosemary
McNamara, Kevin
McNulty, Tony
MacShane, Denis
Mactaggart, Fiona
McWalter, Tony
Mallaber, Judy
Mann, John (Bassetlaw)
Marris, Rob (Wolverh'ton SW)
Marsden, Gordon (Blackpool S)
Marshall, David (Glasgow Shettleston)
Marshall-Andrews, Robert
Martlew, Eric
Meale, Alan (Mansfield)
Michael, rh Alun
Miliband, David
Moffatt, Laura
Moran, Margaret
Morgan, Julie
Morley, Elliot
Mountford, Kali
Mudie, George
Mullin, Chris
Munn, Ms Meg
Murphy, Denis (Wansbeck)
Murphy, Jim (Eastwood)
Naysmith, Dr. Doug
Norris, Dan (Wansdyke)
O'Brien, Bill (Normanton)
Osborne, Sandra (Ayr)
Perham, Linda
Picking, Anne
Pike, Peter (Burnley)
Pollard, Kerry
Pond, Chris (Gravesham)
Pope, Greg (Hyndburn)
Pound, Stephen
Prentice, Ms Bridget (Lewisham E)
Prentice, Gordon (Pendle)
Pugh, Dr. John
Purchase, Ken
Quin, rh Joyce
Quinn, Lawrie
Rammell, Bill
Rapson, Syd (Portsmouth N)
Reed, Andy (Loughborough)
Rendel, David
Robinson, Geoffrey (Coventry NW)
Roy, Frank (Motherwell)
Ruddock, Joan
Russell, Bob (Colchester)
Ryan, Joan (Enfield N)
Sanders, Adrian
Savidge, Malcolm
Sawford, Phil
Sedgemore, Brian
Sheerman, Barry
Sheridan, Jim
Simon, Siôn (B'ham Erdington)
Simpson, Alan (Nottingham S)
Singh, Marsha
Skinner, Dennis
Smith, rh Andrew (Oxford E)
Smith, Geraldine (Morecambe & Lunesdale)
Smith, Jacqui (Redditch)
Smith, John (Glamorgan)
Smith, Llew (Blaenau Gwent)
Smith, Sir Robert (W Ab'd'ns & Kincardine)
Soley, Clive
Southworth, Helen
Spellar, rh John
Starkey, Dr. Phyllis
Stewart, Ian (Eccles)
Strang, rh Dr. Gavin
Stunell, Andrew
Tami, Mark (Alyn)
Taylor, rh Ann (Dewsbury)
Taylor, David (NW Leics)
Taylor, Matthew (Truro)
Teather, Sarah
Thomas, Gareth (Harrow W)
Thurso, John
Timms, Stephen
Tipping, Paddy
Todd, Mark (S Derbyshire)
Tonge, Dr. Jenny
Trickett, Jon
Truswell, Paul
Turner, Dr. Desmond (Brighton Kemptown)
Turner, Neil (Wigan)
Twigg, Stephen (Enfield)
Vis, Dr. Rudi
Walley, Ms Joan
Ward, Claire
Wareing, Robert N.
Watson, Tom
White, Brian
Whitehead, Dr. Alan
Wicks, Malcolm
Williams, rh Alan (Swansea W)
Williams, Betty (Conwy)
Willis, Phil
Wills, Michael
Wilson, Brian
Winnick, David
Winterton, Ms Rosie (Doncaster C)
Wood, Mike (Batley)
Woolas, Phil
Wright, David (Telford)
Wright, Iain (Hartlepool)
Wright, Tony (Cannock)
Wyatt, Derek
Tellers for the Noes:
Jim Fitzpatrick and
Gillian Merron
Question accordingly negatived.
11 Nov 2004 : Column 994
Question, That the proposed words be there added, put forthwith, pursuant to Standing Order No. 31 (Questions on amendments):—
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