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Family Doctor Services

It is a pleasure to follow the hon. Member for Dartford (Dr. Stoate), with whom I served on the Select Committee on Health. I should like to make a few general points about family doctor services. That is the subject of the debate; it is not just about health centres and polyclinics. At the kernel of the debate is a question of honesty and integrity on the part of the Government. I do not believe that they have made the case transparently and openly for a Kaiser Permanente, California model of private sector health provision. They know full well that were they to make that case, they would not get it past their own parliamentary party, the health sector trade unions or other health care professionals. There may be merit in their model, but at the moment we are not having an honest debate about it. It is incumbent upon the Government to put their cards on the table and make the case for polyclinics or health centres. It is ironic that the Secretary of State was in crowing mood. As I said earlier, we always see the vacuity of the Labour party's record and arguments on the health sector when it has to go back 60 years, to historic documents about what was or was not said by general practitioners and medical practitioners in 1947. The fact is that this Government have presided over a doubling of expenditure on the health service but barely any change in outputs and the impact on patients. Their work force planning was described in the Select Committee's report last year as ““disastrous.”” The right hon. Member for Rother Valley (Mr. Barron) was noticeably shy in not sharing that with the House. The Government have presided over a health service in which one is more likely to die of a hospital-acquired infection than, for instance, in a road traffic accident. They will have spent approximately £100 billion on the health service, and we will not take any lectures from a Government who, for example, have increased GP salaries by 50 per cent. for less work. I do not blame the general practitioners for that; it is this Government's cack-handed mismanagement that has resulted in that situation. I well remember that the then Prime Minister came to Peterborough in April 2000 to open the walk-in centre in Midgate, in the city centre. Such centres were then the great thing, the next big thing of Labour's Maoist onward march of health reform. They were going to solve all the problems and take up the slack in the primary care sector. Of course, they are not in fashion now, so we have even more change. My opposition to the scheme is not a knee-jerk opposition to change. Dare I say it, I am quite Fabian in my approach—I believe in the inevitability of gradualism. In such a big organisation, there will always be change, but I object to the top-down approach of the change and the fact that there is no real autonomy, authority or democracy in respect of general practitioners, health care professionals, nurses, managers, elected councillors and others at local level. The change is being imposed. That is to be regretted—a point made by Members across the House. General practitioners in particular need to be properly consulted; they need buy-in to the new health centres or polyclinics. It is no good the Secretary of State, in his rather uncharacteristically sneering remarks, belittling the work of GPs, who are the most trusted health care professionals in the UK—perhaps the only point in my speech with which the hon. Member for Dartford will agree. It ill behoves the Secretary of State to take that confrontational tone, and it is no wonder that such a significant number of GPs are not predisposed to vote Labour at the next general election. I want to give the House a slight history lesson about primary care in the city of Peterborough. The city pioneered collaboration between adult social care and primary care, which the Liberal Democrat spokesman, the hon. Member for North Norfolk (Norman Lamb), described as an exemplar for the country. If I may, briefly, be positive, one of the only aspects of the Government's health policy with which I agree was that they listened to us about Peterborough's primary care reorganisation in 2005. We in Peterborough said that as we had pioneered collaboration between adult social care and primary care it would be ludicrous to throw it away in an unpopular and uncalled-for reorganisation. The Government listened, and the former Secretary of State, the right hon. Member for Leicester, West (Ms Hewitt), threw out the plans. There were other reasons why we insisted that we should have a city-wide health care body or primary care trust. We in Peterborough have specific health needs and health inequalities. Even in a relatively small area such as Cambridgeshire there is a great gulf between the needs of my constituents and, for instance, those in a relatively wealthy constituency such as Cambridge. We have issues around asthma, chronic obstructive pulmonary disorder, diabetes and heart disease. We have a large ethnic minority population who are predisposed to some chronic conditions. We felt that to be subsumed into a greater Cambridgeshire PCT was not appropriate—the fact that the trust was approximately £30 million in deficit at the time concentrated our minds somewhat, too. The Government listened, and we went forward. I pay tribute to the PCT in Peterborough and the professionals who work in the organisation, especially Angela Bailey, the chief executive. However, when I read the proposals and listen to the Secretary of State, I am astonished that a Government who exult in the fact that the NHS is 60 years old and that they were responsible for founding the national health service could really be presiding over changes that would give the sickest, the very oldest, the very youngest and the poorest—the least able to speak up for themselves—a second-class primary health care system. As I said earlier, I cannot believe that of a Government who seem to be having a nervous breakdown in their interaction with those who should be their core supporters. We know that the Labour party has always had a rather sanctimonious, smug attitude—only Labour cares about public health, the poorest people in our society and the health service. Of course, that has never, ever been true.