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Is the Minister aware that recent research has found that when a hospital is built on a 30-year private finance initiative basis, the taxpayer ends up footing a bill of £55 billion for only £8 billion-worth of investment in capital assets? Does the Minister think that that is good value for money?
Caroline Flint: Of course we are not just talking about paying for the building; we are paying for the services as well. We should also be mindful of the fact that when we came to power in 1997 much of NHS stock predated the establishment of the national health service. I am proud that we have been behind a major hospital-building programmenot only hospitals, but LIFT projectsand that we have been working with different partners in the community to provide the best possible health service for all the people of England.
Mr. Bob Blizzard (Waveney) (Lab): Is not the private sectors involvement in public health through the food industrys guideline daily amount food labelling system confusing, complex and requiring of a certain strenuous level of mental arithmetic? Is it not really an attempt to undermine the Food Standards Agencys traffic light system? I can say with some personal authority that showing the red light to fat, sugar and salt is the correct thing to do.
Caroline Flint: It is fantastic that a discussion about which system should be displayed on the front of our packets of meals of whatever sortsuch as shepherds pie or souphas become so prominent in public debate. I personally think that the colour-coded traffic light is easy to glance at, but we, along with the industry and the FSA, have commissioned some independent research to find out what works best for consumers. I would not mind if we had a mixture of both GDA and traffic light; I think that that would be helpful. However, what is important is that we have something that is simple for the public to understand.
Mr. Simon Burns (West Chelmsford) (Con): Has any assessment been made of the impact that the proposed independent treatment centre at Braintree might have on the Broomfield hospital PFI scheme? Will the Minister be kind enough to ask her hon. Friend the Minister of State, the hon. Member for Leigh (Andy Burnham), the answer to Question 18, so that she can tell me when it is expected that that scheme will get the go-aheador that it will not?
Caroline Flint: I understand that there will be announcements soon, and intensive discussions are taking place between the trust, the strategic health authority and officials to conclude the rescoping exercise. I am sure that my hon. Friend the Minister of State has heard the hon. Gentlemans point about where the independent treatment centres fit into that jigsaw.
Bob Spink: I am grateful to the Minister. Does she agree with the Medical Research Council, the scientific community and patient groups that there have been enormously beneficial developmentsfor instance in tackling neurodegenerative diseasesas a result of research combining animal and human materials? Given that she allows research involving human embryos, why is she delaying important research involving chimeras and hybrids? Is that not inconsistent, and is that not putting important medical research in the UK at great risk?
Caroline Flint: We are not seeking to disadvantage research in the UK in this area at all. However, to date, Parliaments stance has been to prohibit the creation of hybrids or chimeras, backed by various committees and expert groups
We think that we should go further than the law currently allows, which is why we propose to make exceptions to the prohibition by way of regulation. As the hon. Gentleman will be aware, the Science and Technology Committee is holding an inquiry, and the Human Fertilisation and Embryology Authority is also discussing and debating this issue. I felt it very important to have pre-legislative scrutiny of changes to human fertilisation and embryology legislation, to make sure that we have as wide a discussion as possible. We are not trying to deter research in the area, but we have to be absolutely convinced that such research can be carried out and regulated in the right way, to make sure that we can take public confidence with us.
The Secretary of State for Health (Ms Patricia Hewitt): By next year, this Government will have trebled investment in the national health service compared with 1997, including substantial extra funding for GP services and a new consultant contract. That has led to 32,000 more doctors in the NHS compared with 1997, and the improving or refurbishing of more than 2,800 GP premises.
Andrew Selous: GPs and consultants are both dedicated and hard-working. Parts of the NHS are clearly short of funds, yet there has been a recent fifteenfold increase in consultants pay, and GPs earn, on average, more than my chief constable, considerably more than a brigadier and nearly four times average teachers pay. Is it not therefore time for us to draw a clear line between the money paid to GPs and consultants to do their job, and the money that they have to provide services?
I am very interested in the implication of what the hon. Gentleman has to say, and I am sure the British Medical Association will be too, since he seems
to be proposing a reduction in GP pay. The reason why GPs are paid significantly more under our new contract is that we were determined to deal with the parlous state of general practice that we inherited from the hon. Gentlemans party and his Government, when thousands of GPs were taking early retirement and medical students simply did not want to become GPs. As a direct result of our new contract, GPs are doing far more to prevent ill health and far more to support people with long-term conditions. The result, as a recent international survey showed, is that our general practice is among the best in the world.
Andrew Gwynne (Denton and Reddish) (Lab): Does my right hon. Friend remember that before 1997 the general public were concerned about the brain drain of doctors going to work in other countries, and will she make sure that we do not return to those days by ensuring that we pay doctors properly?
Ms Hewitt: My hon. Friend is right, and I am proud of the fact that we have more than 32,000 GPs, which is a rise of more than 4,500 compared with 1997, and very nearly double the number of GP registrars in training. That shows that the investment, improvements and reforms that we are making in the NHS are paying off for GPs and their patients. All of them would be put at risk by the policies of the Conservative party.
Mr. Stephen Dorrell (Charnwood) (Con): The Government negotiated a new contract with GPs, defined in it a series of outcomes that the Government presumably want, and linked the payment of improved remuneration to GPs to the delivery of those outcomes. The Secretary of State then made a speech blaming GPs because their income has gone ahead of her budgetary expectations. Is it not hardly surprising, therefore, that morale among GPs is low and that there is a divorce between them and the Government? The GPs feel, If weve delivered what the Government wanted, what more can we do?
Ms Hewitt: I am very surprised that the right hon. Gentleman has not welcomed the fact that there are 360 more GPs in our east midlands region than there were when he left office. We did indeed negotiate with the BMA a performance-related pay contract. Because GPs are doing so much more than we anticipated at the time, particularly on prevention and long-term conditions, they are rightly being paid more. We will of course continue our discussions with the BMA, in order to ensure that the public go on getting the best possible value from that contract, but now that we are giving GPs even greater freedom and responsibility with practice commissioning, I have no doubt that the services that patients receive in the community from general practice will continue to improve under this Government.
Keith Vaz (Leicester, East) (Lab):
My right hon. Friend will know that I had the pleasure of welcoming her excellent Minister of State, my hon. Friend the Member for Leigh (Andy Burnham), to Leicester, East, where he launched a new £12.8 million GP centre for my constituency. I agree that it is important that we should pay GPs a proper salary, but what responsibility will she place on them to ensure that they provide more training contracts for trainee doctors? I have heard anecdotal evidence of students going through medical
school and coming out to find that there are no jobs for them. Can my right hon. Friend ensure that there is more responsibility on GPs to ensure that that does not happen?
Ms Hewitt: I am delighted to hear my right hon. Friends praise for the new GP centre and new health centre in his constituency, and I know that it is excellent. I am glad that the number of GP registrars in training has doubled, as I have said. Although we have some 300,000 more staff in the NHS than in 1997, some newly qualified graduates are finding it difficult to get jobs this year. However, I am glad to say that there are some 2,000 more training places available for new doctors than there are medical graduates in England. I hope that that reassures my right hon. Friend.
Sir Patrick Cormack (South Staffordshire) (Con): Is not the real point of public concern the one raised by the hon. Member for Cannock Chase (Dr. Wright) in Prime Ministers questions last week, when he asked the Prime Ministerand received no satisfactory answerwhy GPs are being paid considerably more and doing considerably less in the way of after-hours and weekend service?
Ms Hewitt: I stress that if a GP practice has decided not to carry on taking responsibility for out-of-hours servicesand most of them chose not to do soit does not get paid for that service, which is then the responsibility of the primary care trust to provide. In most places, that system works very well. GPs are earning more because they are doing more. In particular, they are doing more to care for people with long-term conditions, such as coronary heart disease, and there are thousands of people who are alive today as a direct result of the new contract. I would have thought that the hon. Gentleman would want to congratulate GPs on that achievement.
Mr. Stephen O'Brien (Eddisbury) (Con): Will the Secretary of State tell us why on 17 January she told the BBC that the Government should have insisted that the new GP contracts limit the profits that hard-working GPs can earn in relation to total income, but on 4 February she told ITV that she did not believe in capping GP profits? She is all over the place. Will she tell the House her view today?
Ms Hewitt: I have made it clear ever since I became Secretary of State for Health that part of our responsibility is to ensure that we get the best possible value for the increased investment and contributions that we have asked all our constituents to pay. As I have indicated, the main reason GPs are being paid significantly more is that they are doing more under the quality and outcomes framework. It is also true that a number of GP practices are taking a larger share of the practice income as profits. That is of course an issue that we will continue to discuss with the BMA to ensure that the increased investment that we are making in GP practices continues to be reinvested for the benefit of patients, as well as giving GPs the fair return that they deserve.
to contribute one extra day of work without additional pay?
Given the mess that Ministers are making of the NHS, with community hospitals under threat and physiotherapy, midwifery and health visitor jobs cut, and an inherited deficit for that trust of £17 million, which is carried forward year after year, would not it be more logical for Ministers to give up a days pay and contribute it to the trust?
Ms Winterton: I know that the trust wrote to its employees and that that followed the setting up of a clinical governance group, which considered possible measures in response to a projected overspend of some £5 million. In retrospect, the group, which included staff representatives, felt that it had gone slightly over the top in that request. The trust is still looking for ways to cut backfor example, on agency and bank staffbut it is rightly also seeking to ensure that it breaks even at the end of the financial year.
13. Paul Rowen (Rochdale) (LD): What requests she has received from overview and scrutiny committees in Greater Manchester to review the Making It Better and Healthy Futures consultations. 
The Minister of State, Department of Health (Ms Rosie Winterton): My right hon. Friend the Secretary of State today has asked the independent reconfiguration panel to undertake a review of the issues raised in relation to the reconfiguration of in-patient services for women, babies, children and young people in Greater Manchester.
Paul Rowen: I welcome that announcement from the Minister. I am sure that she is aware of the strong feeling in Rochdale about the Rochdale infirmary. The campaign to preserve that hospital is ably led by Father Arthur Nearey, the chairman of the Friends of Our Hospital group. What is the time frame for the inquiry? Will the Friends of Our Hospital group be consulted on the proposals that are made?
Ms Winterton: There will certainly be full consultation on the proposals. We will announce the timetable in due course. The area to be covered is rather large, so I expect the consultation to take at least three months.
Graham Stringer (Manchester, Blackley) (Lab):
One can imagine that the news that there is to be another stage in the process will not be welcomed in those areas of Greater Manchester where people had thought that maternity and paediatric services were established. My
constituency is one of those areas, so what reassurances can my right hon. Friend give me that ministerial commitments made on the Floor of the House about the future of secondary paediatrics and maternity services at North Manchester general hospital will be met by the further review?
Ms Winterton: As I am sure my hon. Friend knows, a very clear process exists for these matters. The proposals will go before the joint overview and scrutiny committees, which will look at all the relevant clinical evidence and take into account all the points that have been made in the consultation process so far.
That leave be given to bring in a Bill to make provision about access to contraceptive services; and for connected purposes.
This Bill is very timely, given that contraception awareness week starts on Monday. This Government have an excellent record on sexual health, having made it one of the top six priorities for the first time in the history of the NHS. There has been unprecedented and much needed investment to fight the large numbers of sexually transmitted infections and bring down teenage pregnancy rates in the UK. They are the highest in Europe, and HIV is also on the increase.
Condoms are the focal part of the Bill, and they are still the best form of contraception both to prevent pregnancy and to stop the spread of sexually transmitted infections, including HIV. The Bill has three main objectivesto include condoms in the category of free contraception that may be dispensed without charge by general practices, to ensure that commissioned sexual and reproductive health services include the free provision of condoms, and to require that any publicity material on sexual health provided in a general practice will promote the availability of free condoms to those who want them.
General practitioners provide 80 per cent. of contraception for people in the UK, and contraception has been free on the NHS since 1975. There are 14 different types of contraception available, and GPs can provide all of them freewith the exception of condoms. Neither male nor female condoms are included in what GPs can provide free. Although some GPs set aside part of their budget to allow free provision, that is by no means universal. The Bill seeks to correct that strange anomaly. It is a historical legacy that condoms are not freely available at GPs surgeries, and given the massive preventive benefits that greater access to condoms would bring, it is time to right that wrong.
When contraception was first prescribed free of charge on the NHS in 1975, condoms were exempt because they were classed as non-medical devices. I recently found an article written by Toni Belfield from the Family Planning Association in 1989almost 20 years ago. Depressingly, it highlights the same anomaly and quotes from a GPs letter to the British Medical Journal in 1975:
It is surely the last straw if the government intends to insult us by filling up our surgeries with lots of louts queuing up for the issue of condoms.
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