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Polyclinics

I wished to speak only because I have been genuinely shocked by aspects of the campaign that has been waged on this issue. Perhaps I am too easily shocked, but there has been a dishonesty in some of the campaigning that has caused much anxiety and even illness in some people. I had an elderly lady phone my office this week, and she said that when she had gone to her GP surgery she had been told that it would close. I checked with the PCT which told me that the surgery had plans to expand. It may seem clever to campaign in that way, but for people who claim to be concerned with the health of others, it is having a serious and damaging effect. It is worth remembering that we have been here before, when it comes to the NHS and the BMA. When the NHS Act 1946 received Royal Assent, the chairman of the BMA commented:"““The Act is part of the nationalisation programme which is being steadily pursued by the Government.””" Section 21 of that Act stated:"““It shall be the duty of every local health authority to provide, equip, and maintain to the satisfaction of the Ministry, premises which shall be called 'Health Centres'””." The BMA said that health centres would be introduced over its dead body and, indeed, 10 years after the NHS was established, there were only 10 health centres in this country. That was because the GPs, represented by the BMA, would not have them. It has taken us a long time to realise that having a network of well equipped and professional health centres will have an immeasurably beneficial effect on the health of the population. When I was elected to Parliament in 1992, the report from the director of public health in Staffordshire said that my constituency, a former mining area, had the worst health, the greatest number of single-handed GPs and the highest incidence of secondary referrals from GPs to hospitals—usually an indicator of insecure medical practice—in the area. It was essential that that situation be transformed, and I can report that in many respects it has been. Because of investment, we now have a raft of state-of-the-art health centres across the district. Nobody would now claim that such developments are not beneficial to the health of the population. The idea that anybody could have resisted the development of health centres sounds so ludicrous now, and it will seem ludicrous in the future that anybody could resist the development of the next stage in health care, which is what we are talking about now. I am a great admirer of the primary care system of traditional family doctors, but unfortunately it has to be said that it has been very difficult over the years to make the necessary reforms of that system. To compress a short history, I was alarmed for many years that there was no proper system for the clinical audit of general practitioners. It took the horrors of Shipman to produce that system. We have to be realistic and say that it has taken muscle from the centre and often deeply disturbing events to get the general practice system to reform in the ways that it should. I was interested to hear the comments made by the hon. Member for Wyre Forest (Dr. Taylor). I greatly respect him and his experience. I do not want to misinterpret him, but I think that he was effectively saying that if the primary care system had developed in the way that it might have, with extended services, the need for these proposals would never have arisen. However, that is not what has happened. The system has resisted all proposals to extend. We need only think of the arguments that we have had just to get a modest increment in evening or Saturday morning provision, which was standard when I was growing up—it was quite normal to have evening surgeries or Saturday morning surgeries. We have now had to pay the doctors more to return to a system that we once had. It is bewildering that we cannot understand that it is possible to extend GP provision in a way that will genuinely extend choice and access for patients. We think about patient groups, and when my children were small we would have been heavy users of a super-surgery in our area. All we had, when children were inconvenient enough to get ill out of doctors' surgery times, was the prospect of a visit from an out-of-hours person who knew nothing about us and had no diagnostic back-up of any kind, or of taking the children down the local accident and emergency, which was probably inappropriate. The idea of having an intermediate centre for such situations, just so that tests could be done and people could be checked over, seems a genuine extension of patient choice.