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The Minister of State, Department of Health (Mr. John Denham): GPs do a vital job exceptionally well, so the retention of experienced and skilled GPs is crucial to the successful delivery of the NHS plan and a modernised NHS.
In his Budget statement, my right hon. Friend the Chancellor of the Exchequer announced a new fund to tackle shortages of key staff in the health service. Some of it will be devoted to the creation of incentives for experienced GPs to remain in practice, and to encouraging GPs currently on retainers to increase their NHS commitment. My right hon. Friend the Secretary of State will give further details later.
Mr. Denham: What is important is that we underline our commitment to putting general practice at the heart of our NHS reforms. We are already doing that with the creation of primary care groups and, now, primary care trusts. Measures that we are taking today to encourage further GP recruitment will help to bring into general practice the extra numbers that we have promised. We are also taking measures to reduce GPs work loads by cutting bureaucracy, and we wish to develop extended roles for other members of the primary care team staff so that GPs can concentrate on the patients who need their support most.
Mr. Bill O'Brien (Normanton): I welcome my right hon. Friend's statement on the provision of additional support for GPs, which is obviously an urgent matter. However, will he also take into consideration current patient waiting times to see GPs? I have problems in my constituency with that matter, and it would be helpful if he would examine it with some urgency with a view to reducing waiting times for patients.
Mr. Denham: My hon. Friend makes a very important point. We have said that by 2004 we want patients to be able to see a GP within 48 hours. We are already showing, in the work done by the primary care development team, how practices can reorganise themselves to meet that access target without--this is very important--increasing the work load and burden on GPs. Additionally, we have allocated funds from the record investment that we are making this year in the NHS to enable primary care practices to extend and improve patient access.
Mr. David Tredinnick (Bosworth): Does the right hon. Gentleman agree that one of the best ways of retaining GPs and cutting surgery waiting times is to make greater use of complementary and alternative therapies? Is he also aware that many doctors refer to a proportion of their cases as heart-sink patients whom they cannot help, whereas 70 per cent. of those patients get relief if they are referred to acupuncturists, herbal medicine practitioners or homeopaths? Does he not think that now that 30 per cent. of the United Kingdom population have tried herbal medicines, it is time that the Government responded positively to the Lords report on complementary medicine and made such medicine more widely available on the national health service at the point of delivery?
Mr. Denham: I congratulate the hon. Gentleman--whom I always think of as the hon. Member for Holland and Barrett--on his consistent contribution to our debates. Clearly, there is a level of interest among GPs in making use of complementary medicines. The British Medical Association has produced guidance which has been
Mr. Peter L. Pike (Burnley): Does my right hon. Friend accept that Burnley and east Lancashire are areas of deprivation where there are health problems because of some of their traditional industries? Does he also accept that they are also the very areas where it is difficult to retain GPs and to attract new GPs? Will he ensure that money is targeted towards attracting and retaining the GPs whom we need to provide services in such areas?
Mr. Denham: One of the measures that my right hon. Friend has announced today is a £5,000 payment to newly qualified GPs finishing their period as a GP registrar and entering general practice. The payment will be £10,000 in deprived and under-doctored areas. We have taken that action not only to increase the proportion of doctors entering general practice, but particularly to encourage them to work in areas that are currently short of doctors or facing high deprivation levels. I hope that my hon. Friend will feel that we have tried to design the scheme that we have announced today around the types of needs that he has described.
Rev. Martin Smyth (Belfast, South): We welcome the attempts being made to reimburse GPs. However, as the father of a GP--I declare an interest--may I ask what research has been done into why 40 per cent. of GP trainees do not enter general practice? Is the Minister convinced that it is simply a matter of money, or does he think that other action is needed to reform the system, so that we can not only attract GPs but retain them?
Mr. Denham: That is a very good question. There is no doubt that the financial incentive that we announced today, which has been welcomed by the BMA, will help. However, there are other barriers. One is that it can seem to be a fairly daunting step to move from the fairly structured environment of training to taking on the full responsibilities of a GP principal. Therefore, one of the additional measures accompanying the financial package which we have announced today is 20 days of additional training in the first year of practice as a GP principal--something that has been argued for by the BMA. By doing that, we hope to provide greater support for doctors who want to go into general practice. We want to ensure that they can maintain their professional skills and overcome the inevitable challenges of their first year in practice.
Dr. Liam Fox (Woodspring): According to this week's edition of the Doctor newspaper, 70 per cent. of GPs surveyed supported some form of action to highlight their "anger and disillusionment" with the Government. The Government have been in office for four years, so how does the Minister account for that finding?
Mr. Denham: One of the things that GPs know is that for the past three years this Government have paid pay review body awards in full and without staging. In contrast, the Conservative Government regularly failed to
One of the problems is that there are currently too few GPs. I remind the hon. Gentleman that the number of GP registrars fell by 20 per cent. under the previous Government. Under this Government, there have been four consecutive years of increase in the number of GP registrars in training. That means that there will be more GPs in the future, and that we will achieve our target of at least 2,000 more GPs by 2004. As has so often been the case, we have had to undo the damage done by the previous Government. If there had not been the cut in the number of GPs in training under the previous Government, it is a reasonable assumption that we would have 700 more GPs in the NHS today than we do.
Dr. Fox: The real causes of GPs anger and disillusionment have been four years of non-stop reorganisation and change, increased centralisation by the Secretary of State, the scapegoating of the profession by Ministers in this House, increased paperwork and form-filling, and less time for patients. All of that has led to the lowest morale that anyone can remember.
The Minister has just told the House that he accepts that there are too few GPs. Will he therefore say why his team of Ministers told the pay review body this year that the Department's findings showed no support for suggestions of a retention problem? They said that
Mr. Denham: The number of people leaving general practice is at its lowest level for five years. That is a fact. We are addressing the real problems that we inherited from the previous Government, who failed to train enough GPs and nurses or to invest enough in primary care. We have shown our commitment to putting primary care at the front line of the new NHS by saying that we will devolve £25 billion of NHS resources to primary care, to be controlled by primary care groups and primary care trusts. Those resources will give GPs and other practice staff a say in and an influence over the shape of the NHS that they have not had previously.
Practice facilities will improve as we continue to invest in GPs and link them to NHS Direct. In addition, the 3,000 premises that will be modernised under NHS LIFT will mean that GPs will have better premises from which to work. The neglect of the NHS that was the hallmark of the previous Government is being reversed--in primary care as well as in hospitals.