Official Report search · Parliament Workbench

Chamber

Plenary, 25 Apr 2002

25 Apr 2002 · S1 · Plenary

Item of business

Primary Health Care

Chisholm, Malcolm Lab Edinburgh North and Leith Watch on SPTV

Our agenda of investment and reform is a collaborative venture that involves patients and front-line staff wherever they are based. Our focus is the patient and their journey within and across care sectors. Integrated care and single-system working will be required ever-increasingly. In that context, I have a passionate commitment to primary care, which is at the heart of my vision for the future of health care in Scotland.

Our test for new and existing NHS services will be this:

"If it can be done in primary care, it should be done in primary care."

We want people to have ready access to the most appropriate member of the primary care team for such services. We want the services to be part of an integrated, joined-up health and social care system that is designed to meet the needs and wishes of patients. We want primary care teams to drive reform of the NHS, so that people will receive the services that they need, in the right place and at the right time.

Ninety per cent of patient contacts with the NHS begin and end with primary care, which is the gatekeeper to most other parts of the NHS. People value the services that they receive and the staff who provide them. We want to ensure that we continue to develop and enhance those services through our reforms. However, sustainable change will be possible only with the continued support, dedication and hard work of the people who work day in and day out in primary care, caring for patients and working with communities. I thank those staff and pay tribute to all that they are doing and will do in leading change. It is critical that we work in partnership with front-line staff to achieve the level and pace of change that we need to deliver our vision.

Primary care is also a key element in our health improvement and public health agenda for tackling inequalities and raising the health status of individuals and communities. Primary care must be an integral part of the wider drive for social justice, and primary care teams must work with other agencies and local communities.

This summer's decisions on the near 50 per cent increase in health spending that was announced after last week's budget will link investment to evidence of right-place, right-time care and intervention. Nowhere will that be more important than in primary care. The potential is huge for improvements in the experience of patients and the effectiveness of the NHS. That is why we intend to back local primary care teams in taking a central role in leading reform in the NHS. Those professionals—general practitioners, nurses, pharmacists, dentists, health visitors and others—see patients most often and know best their needs. They must be the leaders of change who drive forward the development of care and the redesign of services around the needs of patients.

The transformation in services has begun. However, to speed up the pace of change, we must give front-line health professionals access to the investment and support that they need. That is why we have announced some £30 million of dedicated additional resources for local services, which will be spent through primary care teams on extra staff and equipment. That is also why I support further devolution of funding and decision making to local primary care teams and why I urge all those who work in primary care to play a full and active part in the high-level review of NHS management and decision making that is now under way. A key part of the review's remit is to focus on the developing role of local health care co-operatives in our unified health care system.

In view of comments that were made on the radio this morning, I want to make it absolutely clear that this announcement has nothing to do with GP fundholding. GP fundholding was bureaucratic and competitive and it institutionalised inequity. We will therefore reject the Conservative amendment.

Of course, we want to give choice to patients—we made that clear last week. Patients and GPs can, for example, express a preference for a hospital that can offer a shorter waiting time. Such referrals can take place without GPs' requiring funds to purchase secondary care. The money can simply be transferred. I await with interest the SNP's position on that. If the SNP amendment refers to the devolution of power and resources to local health care co-operatives in our sense, I could accept it. However, if it means LHCCs holding funds for commissioning secondary care, I will not support it because it would set up unnecessary bureaucracy.

Search Hansard contributions

Plenary, 25 Apr 2002

In the same item of business