---

Out-of-Hours Care

From what I have read of that group, my hon. Friend's remarks are very worrying. The hon. Member for Wyre Forest (Dr. Taylor) spoke of the 111 system, which will be excellent. I am pleased to see that the pilots may be ready as early as May or June. He made a point about the BMA involving GPs in commissioning, but I would go further and look for more nursing staff to be involved in the commissioning of services. As usual, the comments by the hon. Member for Mid-Bedfordshire (Nadine Dorries) did not disappoint me. I thank all hon. Members who contributed to this debate and I know that they would want to thank NHS staff. Illness, accidents and ailments pay no attention to the time of day, so we must do all that we can to ensure that patients get the right treatment, at the right time and in the right place, and we must have a system of out-of-hours and urgent care that is achieving that goal. People can now access the NHS in more ways than ever before: through one of the 112 new GP surgeries in the areas with the fewest doctors and the greatest need, and through the new GP-led health centres, of which there is one in every primary care trust, open from 8 am until 8 pm, seven days a week, 365 days a year—there is an excellent one up and running in the heart of Hounslow, and the treatment for my constituents is second to none. People can also access the NHS through local pharmacies, some of which are now open seven days a week and into the night; through minor injuries units and urgent care centres, many of which are nurse-led; and through NHS Direct, either over the phone or online. With so many options to choose from, it is important to give patients and local communities the information to get the help that they need. The hon. Members for North-East Cambridgeshire (Mr. Moss) and for North Norfolk talked about the patient, Mr. David Gray. Many have expressed their concern and sympathy about that case, and I would like to align myself with that and with the dignity shown by the hon. Member for North-East Cambridgeshire. We owe the NHS a great tribute, but we also owe our patients and constituents right and safe care, whether in respect of long-term conditions or urgent dental treatment—many of our dental practices also operate out-of-hours services. Many dentists should be commended for their work rather than constantly criticised for a lack of commitment. They want to contribute to primary care in every way possible by being at the heart of our communities, and many want to, and will, work in the walk-in centres of the future. We are encouraged by the people who work in the NHS and, in particular, by how people want to work in communities. It has been difficult to correct the out-of-hours service, which before 2004 was not effective, but equally the schemes now in place will need the review to be led by Professor Stephen Field. When he reports back, which should be soon, I believe that we will act on it. We have said that we will address the areas of change in relation to the European rulings, and that we will look at commissioning, because that is key to providing the correct services for all patients. Any GP working for out-of-hours providers is subject to the same checks as all other doctors working in general practice in England. Employers have a duty to ensure that all the doctors whom they employ are suitable for the provision of the services that they are employed to provide, and all doctors, including locums, must be on a PCT's performers list before they can provide primary medical services. Concerns about individual doctors can be investigated by the GMC, which can, when justified, remove a doctor from the medical register on fitness-to-practise grounds. All our services must be safe and of a high quality. They will be checked by the Care Quality Commission or the other regulators that will be needed. When I look at the extension of patient services since the resources that have been put into the health service, I feel confident that we will continue to improve our practices in every way possible for our constituents, and that is thanks to NHS staff and the commitment that they show. Question put (Standing Order No. 31(2)), That the original words stand part of the Question. The House divided: Ayes 176, Noes 267.