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Family Doctor Services

I am no expert on the hon. Gentleman's constituency but, as was said earlier, and not by me, there is and should be flexibility. It might be the local community hospital that delivers the service. That might be a structural matter. Years ago I visited some of the community hospitals outside my constituency; they were so old that they were hardly suitable for the 20th century, let alone the 21st. A decision will have to be taken at local level about how and where the service is provided. The motion states that the Opposition are against the imposition of polyclinics"““against local health needs and requirements””." What is the evidence? There is little evidence. Most decision making in the national health service could hardly be called evidence-based. On the contrary, it is often a matter of wetting one's finger, putting it up in the air and seeing which way the wind is blowing. This is the first time I have said that, but it is a true representation of how decisions have been taken for the past 59 years. The hon. Member for Peterborough (Mr. Jackson) mentioned Kaiser Permanente in California. Studies in the US have shown that where there are more primary care practitioners on the ground—not just GPs, but other health professionals as well—there are healthier communities. That may be an international finding and it may not be specific to east Yorkshire or South Yorkshire, but in general, it is likely that by expanding the number of primary care health professionals, not just GPs, better health care will result for the people in that area. The Opposition motion opposing the imposition of polyclinics"““against local health needs and requirements””" echoes the BMA brief, which states:"““The BMA acknowledges that there may be a case for establishing a polyclinic in some very specific circumstances, such as where local patients and clinicians agree on a proven need in their area.””" That has been the subject of debate for 59 years in the national health service. Who takes that decision? How is the need measured? I represent an area with very high disease burdens. Fifteen years ago it had the highest patient:GP ratios in England and Wales. It is a little less now because of the action that this Government have taken, but are GPs flooding into South Yorkshire to come and work alongside the hard-working GPs dealing with massive problems at every surgery, because of the difficulties that we have, sadly, with smoking, drinking, eating and the scars that industry has left on individuals? If it were not for the Government changing the GP contract, we would have the same patient:GP ratios that we had previously. I should like to know—I say this to those on both Front Benches and to everyone in the debate—how we measure the needs of communities, if not by looking at the disease burden that they carry and taking the action proposed by the Government to put GP services into those communities? What other way of measuring need is there? I do not know another way. If it is true that in America more primary health care professionals lead to healthier communities, the Government's proposals should be endorsed by everybody, including the medical profession. Most of the Government's proposals in recent months relating to family doctor services have been grudgingly accepted. One doctor turned up at my constituency surgery to discuss the issue of doctors' hours, which went to ballot. The rest of them get on with doing a very hard job under difficult circumstances because of the size of their patient list and the disease burden that those patients carry. The BMA badly misrepresents GPs, as it did on the issue of extending practice opening by a few hours in the evening and on Saturday. The BMA and the GPs within it are badly led. One of my constituents sent me a leaflet picked up in a neighbouring constituency. Headed ““Your family doctor service is under threat””, it states:"““If we don't agree to this, the government has threatened to take this money away from patient services anyway and give it to local Primary Care Trusts (PCT) to fund large town centre 'Superclinics', probably run by private companies for profit. This could be the first stage in privatising all family doctor services and then the whole NHS.””" We heard the hon. Member for Wyre Forest say that family doctor services are not and never have been run by the state. They are private businesses that are run under contract to the state. The hon. Member for Peterborough said that the Labour party always harks back to what happened 60 years ago when the national health service was created. It was on precisely the matter of GPs that Nye Bevan fell out with many people, and I suspect with those on the Labour Benches in the Chamber, although at the time the Chamber had been knocked down for a few years. It was agreed that GPs would not work for the state, although there are some in my constituency and in all other constituencies who work on a salary, and thank goodness they do. That has enabled us to bring down the patient:GP ratios a little. I have had only two letters on the matter, but leaflets like the one that I quoted are outrageous and do the profession terrible harm. A similar one was being circulated in neighbouring Doncaster. I am pleased that my right hon. Friend the Secretary of State stuck to his guns and said that, under the new contract and its treatment of doctors, it is reasonable for us to expect that doctors' surgeries should open on a Saturday morning. They always used to do so when I worked in industry, before I came to the House, and sometimes in the evening, to make it easier for people to attend. I am dismayed at the lack of professional leadership that the BMA provides to general practitioners. Dr. Laurence Buckman wrote an article on family service access. I have met him a couple of times and he is obviously an independent-minded person. In the ““Royal College of GP News”” in February 2008, he is quoted as saying:"““If there is a boat I'll rock it…I don't shy away from confrontation—people need to hear our point of view. I first got involved with the BMA because I was an angry young man with something to say and I still feel the same way now.””" The last trade union leader to say that was Arthur Scargill, and look what happened to the coal mines. I do not think that the GP surgeries in the Rother valley will suffer the same fate as the coal mines, but that is not good, sensible and responsible leadership. Dr. Buckman went on to say:"““Politicians aren't primarily interested in the health service; they're out for what will be good for themselves and their constituents.””" That is absolutely right. After 59 years of being dictated to by those who work in the health service as opposed to those who need to use it, I could not agree more. If this man was representing me, I should be going along to the next branch meeting.