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Family Doctor Services

The hon. Gentleman has not been listening carefully, and he cannot have read the speech by my right hon. Friend the Member for Witney (Mr. Cameron) to the King's Fund on Monday. My right hon. Friend made it clear that we do not oppose change in general practice, but it must be driven by GPs themselves. [Hon. Members: ““Why?] It must be driven by GPs in response to the needs of patients—it would be useful if the Secretary of State were to read the Opposition motion. The Government amendment does not provide any evidence that the Secretary of State sees any role for GPs or clinicians in interpreting the needs of patients, so I do not know how he thinks that patients' needs will be met. For the PCT to contract with additional practices to provide additional services in under-doctored areas is fine—we have always said that, and there is no reason why it should not go ahead. There is no reason why services that can be delivered more effectively in the community should not be delivered in the community, and there is no reason why GPs should not be able to commission services from a hospital or a community provider transferring services into the community. Sometimes, the hospital itself can provide those services, which certainly can involve diagnostic and treatment services. There will even be places where GP practices conclude that their premises are so poor that they need to come together in larger practices and premises. None of that causes me any problem at all. Because the hon. Member for Wolverhampton, South-West (Rob Marris) represents a constituency in Wolverhampton, perhaps he has not carefully examined the Darzi plan in London and what is currently being rolled out in every PCT across the country in a one-size-fits-all fashion, which is the creation of polyclinics. The Darzi plan in London makes it clear that a polyclinic is 25 GPs occupying 16,000 sq ft costing £800,000 a year with all the services in that place. Where are those polyclinics being put? Last week, I was in Bexley, where a polyclinic is being located on the site of Queen Mary's hospital, Sidcup. In Epsom, a polyclinic has been proposed for the site of St. Helier hospital. That is not taking care closer to home; that is centralising primary care, which will take it further away from the people whom it is meant to serve.