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General Practitioners

Volume 181: debated on Tuesday 20 November 1990

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To ask the Secretary of State for Health what is the average number of patients and income of general practitioners in England and Wales; and if he will make a statement.

On 1 October 1989, the latest date for which information is available, the average number of patients on a GP's list in England and Wales was 1,962—14 per cent. fewer than in 1979. The intended average net income for GPs is currently £33,280 and will rise to £34,680 from 1 January 1991.

Will my right hon. Friend confirm that since the introduction of the new contract and over the past few years, GPs have had fewer patients on their lists and will therefore have more time to treat them? Will he also confirm that as a consequence of the new contract, GPs' incomes will increase, so in no way can it be said that their standard of living has been eroded?

I can confirm what my hon. Friend says. I remind the House that many statements were made about the effect of the new GP contract and a lot of words will have to be eaten, particularly by Opposition Front-Bench Members. The figures already coming through show dramatic rises, for example, in the immunisation of children, which I do not think would have been achieved without the contract, which is already working well.

How many applications have there been from general practices in England and Wales for budget-holding status? How many of them came from rural areas? When will the Secretary of State make an announcement about those that he will approve?

The number is about 350, with a similar number, or rather more, expressing interest for the future. I cannot give the hon. Gentleman the breakdown between rural and urban now, but I shall write to him about that.


To ask the Secretary of State for Health what has been the effect of the new general practitioner contract on the amount of time spent in consultation with patients.


To ask the Secretary of State for Health what recent representations he has received about the new contract for general practitioners.

A recent survey published in the medical press suggested that 54 per cent. of GPs have spent more time in patient contact since the introduction of the GPs' new contract. In recent months there has been a dramatic reduction in the volume of correspondence received on the GP contract.

When the new contract was negotiated, doctors expressed much concern about targets for cervical cytology and immunisation. Does my hon. Friend have figures to show the percentage and number of doctors who are achieving those targets? Has the number of home visits undertaken by doctors personally rather than through agency services increased since the new contract was agreed?

My hon. Friend rightly highlights the misleading and mischievous statements that were made at the time. The hon. Member for Livingston (Mr. Cook) said:

"The targets … for screening for cervical cancer—are so heroic, so far beyond the present figure for most practices, that there is a danger that many doctors will simply give up trying."—[Official Report, 25 July 1989; Vol. 157, c. 960.]
That shows, as ever, that the Opposition think so little of people and are the doom-mongers and gloom merchants.

I shall give my hon. Friend the figures that he requested: 54 per cent. of GPs are already hitting the higher target for cytology—the majority are hitting the higher target. A further 35 per cent. are hitting the lower target as well and that is very encouraging. A similar story applies to immunisation. The remuneration on home visits, whereby if a GP carries out his own home visit at night, he receives about £45, but if he uses a deputising service, he receives £15, has meant that GPs are more willing to undertake their own home visits.

Does my hon. Friend agree that one of the likely reasons for the reduction in correspondence on this subject is that the contract is now a great deal more popular and more widely accepted, not only among GPs but among patients, than it was when it was first proposed? Is not one of the reasons for that that patients have more information about the services that are available to them than they have ever had before? [Interruption.]

On a point of order, Mr. Speaker. Could we have some quiet? There is a lot of last-minute canvassing on Conservative Benches. These are important Health questions.

I have to say that the noise comes from the hon. Member's side of the House as well—[Interruption.] However, I thank the hon. Member for drawing his point of order to my attention. It gives me the opportunity to say that we should listen to Health questions in silence.

The GP contract is a great success, partly because it has been backed by resources. In the part of the world of my hon. Friend the Member for Richmond, Yorks (Mr. Hague), there has been a 20 per cent. increase in practice staff over the past year and a 65 per cent. increase in practice nurses. He will know that in his part of the country the average GP list size has come down from 2,000 to 1,700. Certainly, his point is important. The GP contract means that more information is made available through practice leaflets and the local directory of services. Patients are better informed. They are treated like partners by the GPs. It is a success for the GPs and a success for the patients.

The Minister mentioned cervical cancer a moment ago. Is she aware that the research unit at Hammersmith hospital, which is looking into breast cancer, now faces closure because of the inability to get £150,000 a year to continue its work, when her Department spent £147,000 on hospitality last year? Will not she say that it is a most inappropriate use and misallocation of resources and that she will keep the Hammersmith breast cancer unit open?

Clearly, as the first country in the European Community with a national call and recall system both for cervical cytology and for breast cancer, we are determined to reduce the number of avoidable deaths by cancer, particularly cancers affecting women. We have not had an application from the Hammersmith unit. We have been in touch with it to see whether there is any way in which we can assist.