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Parliamentary Debates (Hansard) Tuesday Volume 522 25 January 2011 No. 105 HOUSE OF COMMONS OFFICIAL REPORT PARLIAMENTARY DEBATES (HANSARD) Tuesday 25 January 2011 £5·00 © Parliamentary Copyright House of Commons 2011 This publication may be reproduced under the terms of the Parliamentary Click-Use Licence, available online through the Office of Public Sector Information website at www.opsi.gov.uk/click-use/ Enquiries to the Office of Public Sector Information, Kew, Richmond, Surrey TW9 4DU; e-mail: [email protected] 145 25 JANUARY 2011 146 that PCTs should be offering emerging consortia. Milton House of Commons Keynes PCT has confirmed that it will actively support Premier MK, one of two consortia in the area, with its Tuesday 25 January 2011 application to become a pathfinder, and that it is actively working with another consortium in the Milton Keynes area. The House met at half-past Two o’clock Stephen Mosley: Pathfinder consortia will play a crucial role in improving the NHS, so it is imperative that any PRAYERS problems are sorted out as quickly as possible. How does my right hon. Friend propose to help any pathfinder [MR SPEAKER in the Chair] consortium that finds itself in the unfortunate position of failing to deliver the results expected of it? Mr Lansley: My hon. Friend makes an important Oral Answers to Questions point. He will recall that before the election, the Select Committee on Health severely criticised the way in which primary care trusts were going about commissioning. We are looking to consortia because they are clinically HEALTH led and responsive to patients in designing far better clinical services, and they will have considerable support The Secretary of State was asked— in doing so. Over the next two years, we will enable them to develop support arrangements, whether through GP Commissioning existing primary care trust teams, local authorities, the NHS commissioning board, or a range of voluntary 1. Mark Lancaster (Milton Keynes North) (Con): and independent sector organisations. What recent progress he has made in introducing GP Nick de Bois: Will the Secretary of State outline the commissioning consortia. [35632] role that charities and voluntary organisations will play 3. Stephen Mosley (City of Chester) (Con): What under GP commissioning to ensure that the needs and recent progress he has made in introducing GP views of patients are at the heart of services? commissioning consortia. [35634] Mr Lansley: To give my hon. Friend one example, last 6. Nick de Bois (Enfield North) (Con): What recent Friday I spoke to the Motor Neurone Disease Association, progress he has made in introducing GP commissioning which has developed a commissioning support organisation consortia. [35637] with the Multiple Sclerosis Society and Parkinson’s UK. The voluntary sector can therefore be involved 8. Mr Matthew Offord (Hendon) (Con): What recent directly in helping GP consortia to commission for progress he has made in introducing GP commissioning those critical diseases more effectively. My hon. Friend consortia. [35639] might have seen what Sir Stephen Bubb, the chief executive of the Association of Chief Executives of Voluntary 11. Christopher Pincher (Tamworth) (Con): What Organisations, said last week: recent progress he has made in introducing GP “These reforms could herald a new and dynamic relationship commissioning consortia. [35642] between local GPs and charities that both deliver good services and act as a powerful voice for patients.” The Secretary of State for Health (Mr Andrew Lansley): Last week, I announced the second wave of GP-led Mr Offord: My constituents in Hendon are eager to pathfinder consortia. There are now 141 groups of see the improvements in health services that I believe GP practices piloting the future GP commissioning GP commissioning will bring about. Will my right hon. arrangements. Those groups are made up of more than Friend give examples of where GPs have had the freedoms 4,000 GP practices, with over half the population starting and responsibilities that we can expect in Hendon? to benefit from services that better meet their needs and improve outcomes for patients. The Health and Social Mr Lansley: My hon. Friend might like to speak to Care Bill, which had its First Reading last week, sets general practitioners in Redbridge in London who, as a out the legislative framework that supports our reforms. pathfinder consortium, have been pioneering GP-led commissioning for 18 months. They have redesigned care Mark Lancaster: Consortia in Milton Keynes have for patients with diabetes and coronary artery disease, been given £1 per patient as a transition fund. That and are shifting care in ophthalmology and dermatology money is most welcome. It will rise to £2 per head next to primary care settings. They are demonstrating how year. The problem, however, is that the fund is proving this form of locally and clinically-led commissioning is hard to access because of the bureaucratic nature of the more responsive to patients and more effective. local primary care trust. Will the Secretary of State look into that and ensure that the money is accessible? Christopher Pincher: As we shift from PCTs commissioning services to GP consortia doing so, can Mr Lansley: I entirely understand my hon. Friend’s my right hon. Friend confirm that the important work point. The PCT’s role is to support the development of done by pharmacies, such as providing anti-smoking consortia, not inhibit it. The operating framework that clinics and the supervised consumption of drug substitutes, was published last month sets out the range of support will not be left out in the cold? 147 Oral Answers25 JANUARY 2011 Oral Answers 148 Mr Lansley: My hon. Friend enables me to say that I managing and monitoring of hundreds of commissioning and my colleagues entirely understand and endorse the contracts will be done not by GPs but in their name, stronger role that pharmacies can play, including by either by the people who do it now in primary care assisting with the provision of services such as minor trusts or by the big health companies that are already ailments services and medicines use reviews, which will hard-selling the service to new GP consortia. Is he not be commissioned through arrangements led by the NHS deliberately disguising the true purpose of his changes, commissioning board. In addition, the services that which is to open up all parts of the NHS to big private he describes, such as stop smoking services, will be health care companies? commissioned as part of the public health efforts, which will be led by local authorities through their local health Mr Lansley: On the contrary, the purposes of the Bill improvement plans. are very clear to see—for example, the duty to improve quality and raise standards throughout the health service. Emma Reynolds (Wolverhampton North East) (Lab): I hope that the shadow Secretary of State will acknowledge Will the Secretary of State comment on the apparent that putting clinical leadership at the heart of the system conflict between, on the one hand, a general practitioner is essential. I entirely understand that leadership is not being an advocate for their patient and taking purely the same thing as management, as do general practitioners. clinical decisions and, on the other hand, GPs having to The Prime Minister and I will meet the first wave of allocate resources in the new system? Will that conflict pathfinder consortia tomorrow, and we will support not lead to a breakdown of trust in the relationship them in taking clinical leadership in designing services between the GP and their patients? for patients and bringing to bear the best management support in doing so. Mr Lansley: I am afraid the hon. Lady sees a conflict where, to GPs, there is none. It is their responsibility— John Healey: Why will the right hon. Gentleman not [Interruption.] No, their first duty is always to their be straight with the public? I have with me the White patients, whose best interests they must secure. When Paper—57 pages and only three references to the market, she has an opportunity to look at the Health and Social all of them to the social market. He talks about GP Care Bill, which we published last week, she will see that commissioning, but not about the hard-line political it makes very clear the duty to improve quality and ideology that underlines these changes. The Bill puts no continuously to improve standards. We all know that we limit on the use of NHS beds and staff to treat private have to achieve that with finite resources, but we will do patients, it puts no limits on big private health care that much better when we let clinical leaders influence companies undercutting and undermining local hospitals, directly how those resources are used rather than letting and it puts at the heart of the new system an economic a management bureaucracy tell them how to do it. regulator charged not with improving services but with Debbie Abrahams (Oldham East and Saddleworth) guaranteeing and enforcing competition. Is this NHS (Lab): Can the Secretary of State explain why, at a time reorganisation not like an iceberg, with the substantial when front-line NHS staff in my constituency and ideological bulk being kept out of the public’s sight? elsewhere across the country are in fear of their jobs, it is proposed that the NHS commissioning board will be Mr Lansley: The shadow Secretary of State cannot able to make bonus payments to a GP consortium if, to actually criticise what we put forward in the White quote the Bill, Paper or the Bill and is resorting to inventing something “it considers that the consortium has performed well”, else and attacking that.
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