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Family Doctor Services

I will not, because I have only a few minutes to respond. The Opposition Front-Bench spokesman took rather longer than I was expecting. Those health centres will allow any member of the public to pre-book or simply to walk in and be seen by a GP from 8 am to 8 pm every day of the week. They will all have a strong focus on promoting health, particularly to hard-to-reach groups, and on preventing health inequalities. When we talk about developing health centres or when some local parts of the health service describe plans for polyclinics, we are not referring to a single, fixed model of care. These terms describe flexible models for bringing primary care together with a range of other services, be they diagnostic services, specialist care for patients with long-term conditions such as diabetes, or social care. Research shows that the public want services that are more joined up, and it shows that more integrated care produces better health outcomes. But there is no one-size-fits-all solution. What matters is doctors, nurses and other clinicians working with the public to design integrated care to meet local circumstances. That is why the Government are providing investment for the new health centres, and why we have given the local NHS the flexibility to design the services that will be based in those centres. Although we are not prescribing specifications for the new services—it will be up to SHAs and PCTs to design those with local communities—we are saying that there needs to be a small number of core requirements, which are expected by the public. For GP practices in under-doctored areas, those requirements include extended opening hours, engagement in practice-based commissioning and wide practice boundaries to secure the maximum level of access. For the health centres in every primary care trust area, those include: an easily accessible location; being open from 8 in the morning until 8 in the evening, seven days a week; bookable GP appointments and walk-in services; services for registered and non-registered patients; and a maximisation of the opportunities to integrate and co-locate with other community-based services. To respond to question put by the hon. Member for Wyre Forest (Dr. Taylor) about the role of the independent sector, even if every one of the new health centres and all of the extra capacity that we are creating in the NHS at primary care level were won by the independent sector—and that is not what is happening—the proportion of provision of primary care run by the independent sector would amount to only 3 per cent. of the national total. I would add that existing GPs are private contractors. It was suggested by a number of Conservative Members that the public were not interested in more flexible opening hours for GPs. They claimed that there was no demand for them. I have to tell them that every single poll—not just those done by the Department, but those carried out recently by MORI and by Which—shows that it is a priority for the public. When record investment is going into GP services, they do not consider it unreasonable to be able to visit a GP at a time that is more convenient for them. The proposals are also popular in rural areas. Dr. Michael Dixon, the chairman of the NHS Alliance, will be well known to many in this House, and he said recently:"““I know that many GPs and others have difficulty with the word 'polyclinic'…but the concept of bringing practices together and providing a greater range of integrated services in the community has to be right…It might be true that small is beautiful, but professional isolation and poorly integrated services are not…Practices need increasingly to work with each other and with other partners in primary care, whether as virtual partners or on one site””." Dr. Dixon, whom I visited with the Secretary of State last week, practises not in inner London or inner Manchester but in rural Devon. His fantastic health centre in Cullompton, far from making it harder for local people to access services, means that many people in the surrounding villages and Cullompton no longer have to travel to Tiverton or further afield to Exeter for treatment. Instead, they can receive them on their doorstep, in their local market town. Moreover, his surgery is about to embrace evening and Saturday morning opening. When one looks at the London model, one finds that 29 out of the 31 primary care trusts in London are already working on proposals—bottom-up, not top-down—for health centres in their areas. A recent survey by the British Medical Association, no less, found that 70 per cent. of GPs in London said that their premises were ““inadequate””.