Mike Penning (Hemel Hempstead) (Con): It is a pleasure both to wind up on behalf of Her Majesty’s Opposition in this important debate, and to follow three members of the Health Committee. Having left the Committee myself only just over a year ago, I know how diligently they work. The Health Committee is one of the great Committees in this House, and I do not hold back in my praise of it—although I wonder whether the Minister might drag himself away from his notes for five seconds and listen to a contribution this afternoon? [Interruption.] I may tease him a bit more, as I have now got his attention.
Interestingly, the Minister was, I think, referring to spin when he complained about the coverage of the Healthcare Commission report in this morning’s press. That is astonishing coming from a member of a Government who have welcomed back into their ranks Lord Mandelson, a man who got his reputation from practising the black arts of spin in the 1990s.
Perhaps I can tease the Minister a little more? On page 68 of that report, reference is made to an access to a GP indicator. The report is not as definitive as it might have been because some areas refused to return any data. One such area was Devon, which is run by the Minister’s own primary care trust. It is a shocking indictment of the Minister that he cannot even control his own PCT by getting it to give data back to the commission, let alone understand what is going on. The Healthcare Commission report is timely—although I am sure the Government were not expecting it to be published at this time when they timetabled this debate for this afternoon.
I will try not to go over the points raised by the shadow Secretary of State, my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), but instead I shall cover some areas I have a personal interest in and some responsibility for. I will come on to urgent care and dentistry, which my hon. Friend the Member for Wellingborough (Mr. Bone) referred to, and polyclinics.
However, I must first highlight something. If Ministers come before the House and make commitments to Members and to the country that they will address certain matters, the public have the right to expect that to happen. Therefore, given that the former Health Minister, the Under-Secretary of State for International Development, the hon. Member for Bury, South (Mr. Lewis), came to this House and promised he would address the 0844 number issue—which is leading to our constituents being ripped off when they phone their GP surgeries—and that that practice would stop, it is astonishing and unbelievable that, in this later debate, Labour and Opposition Members have highlighted the problem of patients still paying these charges.
We must also address the fact that the Government have gone to war with the GPs. I do not understand why, as the Government brought in the new contract in 2004. It was not written by the GPs or the Opposition; it was a Government contract for better health care in GPs’ surgeries. The GPs took it and delivered it to their patients, but then the Government started to attack GPs throughout the country. The hon. Member for Dartford (Dr. Stoate) was absolutely right: morale is not great. For the first time since I have been involved in politics, all the GPs in my constituency have come together with the community to complain about what is going on in health care.
We should briefly address the polyclinics issue—although I know the Government do not like to call them that. The Prime Minister stood at the Dispatch Box and said there will be 150 polyclinics in London. The Darzi report said that, and the Prime Minister said it would be imposed in London. Rightly, London is revolting against that, and areas of London say they are not going to have them. In some areas in London and the country a polyclinic might be a good thing. I listened to the comments of the hon. Member for Dartford; if he has an expanded area and there is no existing provision in it, a polyclinic might well be a good way forward in that part of his constituency. However, it is clear from other Members’ comments that in the other parts of the country where they are being imposed, it is not right that they will be plonked down in the middle of an area regardless of whether there is a need.
I am sure the Minister is aware that I will raise the issue of the polyclinic that is being imposed in the middle of Hemel Hempstead town centre. Every GP surgery has signed an open letter to the PCT, along with myself and the patient groups in the town, saying, “Please do not impose this on us.”
Not one GP surgery in that part of my constituency has a full list. The other evening, I purposely made a 7.30 pm appointment with my GP at one of those surgeries, just to see what demand there was. I could have gone at another time of day, but I booked online and went at 7.30 pm. How lonely I was. I got there five minutes early and was seen five minutes early, because there had been no patients in for the previous half an hour. There was no one booked in after me either. There were two receptionists on duty—quite rightly, because they should not be left alone in that situation at that time of night. The pharmacy attached to the surgery was open, and my GP was there. I saw my GP, and we then left and had a conversation about a lot of other things. The demand is not there. If it were, the surgery would be open at that time day in, day out. The polyclinic is to be only 200 yd to 300 yd away from there.
There are parts of Hertfordshire, in the same PCT area, that might well need such a clinic in future. Some 80,000 homes are being imposed on Hertfordshire, not least 18,000 in my constituency. If those homes are to be built, a polyclinic might well be the right vehicle for delivering primary care to my constituents, but to say that one size fits all around the country is wrong.
I was interested to hear the hon. Member for Dartford, who brings his expertise to the subject, say that GPs have got together to run clinics, but in most parts of the country they are being prevented from doing so. Two of the GP surgeries in my constituency would probably like to join together to run a clinic rather than compete, but they are being prevented from doing so.
I shall touch on a couple of points that hon. Members have made before turning finally to dentistry. The hon. Member for Walthamstow (Mr. Gerrard)—I know that part of the world well, having grown up there—rightly said that there are good GP surgeries and bad, and that some offer more services than others. I am sure that he is aware that because of how the funding formula works within PCTs, some GP surgeries get double the money that others get.
I was interested by the Minister’s saying that one reason for the problems in delivering primary care was the reconfiguration that had taken place around the country. There may be an argument for that, although I have not heard that one before, but in London there was no reconfiguration. The PCTs were left in situ as they were before, so that argument does not stack up.
I agreed enormously with the hon. Member for North Norfolk (Norman Lamb), the Liberal Democrat spokesman, when he talked about his own surveys. We are all doing that type of survey—I am sure that it is not just a Liberal Democrat thing. We all try to make contact with our constituents and find out their concerns. GPs are not happy, and they feel as though they are being persecuted even though they are delivering front-line services to our constituents in a most professional way. Where there are problems, they are for the PCTs to address in their commissioning. That is their role in life.
I was slightly concerned when the hon. Gentleman talked about the Liberal Democrats’ policy that if patients are not treated in a timely fashion, they should be able to go off to the private sector. I would like to see the costings for that, if the Liberal Democrats would like to publish them. It sounds as though they must be quite phenomenal.
Norman Lamb: I mentioned earlier that that policy was based on the Danish system. The evidence from Denmark is that it has massively increased efficiency in the state sector, thereby saving money.
Mike Penning: We examined the methods in other countries in the Health Committee, but a completely different type of health care is provided in Denmark, Sweden and other countries.
As always, it was a pleasure to listen to my friend the hon. Member for Wyre Forest (Dr. Taylor). He is renowned in the House, and particularly in the Health Committee, for his expertise. It is very important that we all understand the type of care that our constituents want. They do not want to go and meet a stranger, or see a different GP every time they need some care. They want the relationship provided by years of work together, often down the family line. Although GPs in Worcestershire were pressed, it is a crying shame that GPs from other parts of the country are coming down to Worcestershire, because Worcestershire GPs probably understand the hon. Gentleman’s constituents much better and would represent the way forward.
We are pressed for time, but I want to make a couple more comments. The hon. Member for Wyre Forest alluded to the fact that we must address the out-of-hours urgent care system. So many people are frightened and need help, and they do not know the myriad of numbers involved. I know that NHS Direct has tried desperately to get its number into the public’s perception, but people still do not know it. The branded number that people know, 999, is sadly being abused on a daily basis. We must get another number branded quickly, before these numbers disappear—the European Union is progressing with these 116 numbers as we speak. He also mentioned the important NHS pathways software, and I have seen it working brilliantly in the north-east.
My final point is about dentistry, which is the part of primary care missing from the Minister’s speech. It is crucial that this Government address the mess that they have created by imposing the dentists’ contract on this country. So many people cannot see an NHS dentist, but they deserve to do so, because that is what they pay their taxes for, and so it is about time that this Government scrapped their ludicrous contract.
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MIKE'S OTHER CONTRIBUTIONS TO THE SAME DEBATE
Mike Penning (Hemel Hempstead) (Con): The hon. Gentleman is very generous in giving way. The undertaking that he is asking for from the Government, and particularly from the Minister, to abolish the use of 0844 numbers was given by the Under-Secretary of State for International Development, the hon. Member for Bury, South (Mr. Lewis), some time ago, when he was a Health Minister, and nothing has happened.
Dr. Stoate: I accept that. I also accept the Minister’s assurance that the matter is being looked into by the Government. I await, as does the hon. Gentleman, the outcome of the Government’s deliberations, and I hope that this will be sorted out quickly. I think I have explained why there is so much variability, why practices have such different approaches, and why some provide services that are not up to the standard that we would like to see, whereas others motor ahead and produce everything that the Government want.
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Mike Penning: Does my hon. Friend think that if he asked his constituents whom they respected most, GPs would be quite high on the list—higher than Ministers or Members of Parliament in general?
Mr. Bone: I should hate to include that question in my survey. If I asked “Do you value your GP or me?”, it would be like the election return in an African republic: 100 per cent. would value the GP and none would value me. So, with all respect to my hon. Friend, I do not think that I shall include that question.
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