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9 Oct 2007 : Column 64WH—continued
Seriously, this is an important debate, and the hon. Member for Kettering raised some valid, legitimate issues on behalf of his constituents. I do not wish to be churlish, but the emphasis and focus of his speech were disingenuous. I shall explain why it is fair to say that.
First, the hon. Gentleman said to GPs in his community that he and his party are on their side and that the Government are doing things to the national health service that are getting in the way of their doing their job. That was his main message. He used anecdotes about individuals to prove a point. I always think that it is unfair to try to talk down the NHS by doing that, as 99 per cent. of anecdotes would demonstrate that people receive a wonderful service.
I suspect that the hon. Gentleman wrote his speech before the announcement at his party’s conference about ripping up the contract that GPs and the Government recently signed. That is now the position of the Conservative party. It has gone down incredibly badly with GPs at a time when the Government’s message is that, yes, we need to make significant changes to primary care, but that we intend to do that in partnership with the profession, building on the contract rather than simply ripping it up and starting all over again. The Conservative policy is putting his party into conflict with GPs who are working hard every day of the week to improve the NHS.
Mr. Hollobone: Will the Minister give way?
Mr. Lewis: I shall make some progress and then give way to the hon. Gentleman. Major progress has been made in Northamptonshire. All Northamptonshire patients are able to see a GP or a nurse for a routine appointment within 48 hours; Northamptonshire practices achieved an average of 960.1 quality points out of a possible 1,000 in the quality and outcomes framework, and 74 per cent. of the population aged 65 and above have been vaccinated for influenza. Across Northamptonshire, all practices have open lists and are accepting new patients—the hon. Gentleman disputes that—and several practices employ highly skilled nurse practitioners who provide a range of services from the management of long-term conditions to diagnosis and treatment of minor ailments.
The performance of the health service in the hon. Gentleman’s constituency has advanced massively in the past 10 years. He will not like my saying this, but a significant reason for that is the near tripling of investment in the NHS that the Government chose to make. The NHS had been starved of resources in the previous 20 years, which meant that the baseline of NHS funding was a scandal when compared with other countries around the world.
The hon. Gentleman is right about growth. The Northamptonshire PCT received growth area adjustment in its 2006-08 revenue allocation to take account of the demographic issues that he properly raised.
Mr. Bone: Will the Minister give way?
Mr. Lewis:
I will give way in a moment. I shall provide some recent information, which is not made up, about what is happening in the hon. Gentleman’s health economy area. Six large extensions opened in 2007—three in Northampton, two in Corby and one in
Daventry—and a new surgery has opened in Higham Ferrers in east Northamptonshire. Two large new medical centres will open within the next nine months in Rothwell and Kettering, and an extension is due for completion in December in Northampton. There are plans to develop health facilities in Kettering, Thrapston, Raunds, Corby and Northampton, and the south midlands LIFT project will see the development of new facilities in Corby, Wellingborough and Northampton.
A new approach to service delivery will involve a series of health hubs providing a wide range of services along the lines of polyclinics. Willowbrook community hospital polyclinic in Corby will have investment of £27 million, and the integrated care centre polyclinic in west Northampton will have investment of £21 million.
My point is that there is now massive, unprecedented and sustained investment in primary care in the constituencies of the hon. Members for Kettering and for Wellingborough. That recognises that patient expectations, technology and science means that health care must be incredibly different if we are to make best use of the new technology and new drugs being created almost daily, and if we are to respond to patient expectations.
Mr. Bone: I understand the Minister’s case, but unfortunately it falls flat when it comes to Northamptonshire PCT because under the national capitation formula, which the Government set up to decide how many millions of pounds each PCT receives, Northamptonshire has received less than 100 per cent. in each and every year since that formula was implemented. Over the past few years, that has equated to £110 million. If the Government implemented their own programme, we would not have a problem, but they do not do so in Northamptonshire.
Mr. Lewis: I shall deal with that accusation head-on. In 2006-07, the allocation to the PCT increased to £730 million—a cash increase of 12.7 per cent. In 2007-08, it received £870 million, which is a further cash increase of 12 per cent. That is a cash increase of 26.3 per cent. over the two years 2006-07 and 2007-08, compared with a national average of 19.5 per cent. The funding formula and the funding system recognise that the hon. Gentlemen’s constituencies have particular issues and challenges that must be addressed.
Mr. Bone: Will the Minister give way?
Mr. Lewis: No. It is exceptionally disingenuous for hon. Members who represent a political party that slashed NHS spending in every part of the country to come here and undermine the massive additional, above-average investment in their communities. We should remember that during the past seven or eight years, that party has repeatedly opposed the additional investment that the Government have chosen to put into the national health service.
It is important that we do not mix up the debate about out-of-hours and emergency services provided by GPs with extended hours in terms of evening and weekend opening. Under the previous system, GPs often worked until midnight or 1, 2 or 3 o’clock in the morning, and then went back to their practices at 8 am
to see patients. That was an unreasonable set of expectations and did not necessarily lead to the best possible, safe patient care. Under the new contracts, GPs were given the option of saying that they no longer wanted to provide emergency or out-of-hours cover, and the PCTs were given responsibility for securing that out-of-hours cover.
The argument about extended hours is that because of labour market realities, choice and preference, many patients would like to be able to see their GPs in the evenings or at weekends. That would be more convenient for patients and a more personalised service. That is the next stage in the NHS transformation that the Prime Minister, Lord Darzi and the Secretary of State have spoken about. Having fixed the NHS and rebuilt its foundations, we must now move to a highly personalised service. I find it astonishing that any Member would stand up here and say that patients are not entitled to that and do not want that. Surely we should create an NHS that continues to be increasingly responsive as society changes. Let us not mix up emergency out-of-hours cover with extended hours and more convenience for patients.
Mr. Hollobone: This is the 10th debate on local issues that I have managed to secure, with the permission of Mr. Speaker, in the past two years, and this is the most inappropriate party political response that I have had from any Minister. This Chamber should be a genuine forum for Back-Bench Members to raise genuine constituency cases. I was not making any political points whatever. Will the Minister confirm that NHS spending in Northamptonshire is based on registered patients at GP practices, and not on the population? On extra opening times for GP surgeries, I was simply quoting to the Minister his Department’s survey data, which show that 85 per cent. of patients in Northamptonshire are satisfied with the current opening hours of GP surgeries.
Mr. Lewis:
The tone of the hon. Gentleman’s presentation was to talk down the NHS and its performance, and to use anecdotes to say that the Government’s desire to respond to patient preference
and choice is misguided. He did not refer to the fact that at his party’s conference, the shadow Secretary of State waged war on the GP profession by saying that the Tory party’s position is to rip up GPs’ contracts.
The hon. Gentleman rightly referred to access to children’s mental health services. The Government have begun to rebuild child and adolescent mental health services—CAMHS—and have put a lot more money into them, but there is a long way to go because, as you are aware, Mr. Taylor, such services were practically non-existent in many parts of the country back in 1997-98. We have two trailblazers and another 11 are starting now. Access to talking therapies through primary care in every community is something that I am proud of, and later today there will be further announcements about health spend over the next three or four years. It is important that, in future, there will be greater emphasis on investing in talking therapies, which can make a massive difference to people’s quality of life and mental health. There was no access to talking therapies in this country when we came into government, and people waited months and years for an operation. By next year, people will wait a maximum of 18 weeks.
The hon. Gentleman’s community should respond positively to the Darzi interim review proposals. There will be more than 100 new GP practices, including up to 900 GPs, nurses and health care assistants in the 25 per cent. of PCTs with the poorest provision. It may well be that the hon. Gentleman’s constituency could benefit from that. New resources will enable PCTs to develop some 150 GP-run health centres, with up to 1,750 GPs and nurses situated in easily accessible locations and offering a range of services to all members of their local population. As a result of last week’s interim review announcement by Lord Darzi and the Secretary of State, the hon. Gentleman may be able to secure even more resources for primary care for his constituents.
The hon. Gentleman raised valid and legitimate issues, but it is important that we do not allow people to suggest that the health service has not advanced massively. In our vision for transformation, personalisation is the next stage, and the Government will match that with continued and sustained record levels of investment.
Adjourned accordingly at Two o’clock.
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