Clinical Commissioning: North Durham

Julie Cooper Excerpts

Wednesday 23rd November 2016 Westminster Hall

[Julie Cooper (Burnley) (Lab)]

I am grateful to my hon. Friend the Member for City of Durham (Dr Blackman-Woods) for bringing this important subject to the fore. I have a few comments. First, on the question of the impact on patients, what assessment has been made about conditions going untreated? There has been nothing about safety implications. Patients could be affected in two ways: a condition might be untreated and, as has been mentioned, their private, confidential information would go to a private company where the people are not medically trained. We have already seen from other contracts, such as with Capita, total disrespect in the handling of patient records.

Secondly, what is happening is a challenge to the professionalism of general practitioners. We spend a lot of time and money, over many years, on training experts. No wonder we cannot retain staff in the NHS if this is how we treat them. Some important questions need to be answered. The whole thing is cloaked in secrecy. There is an underhand feel to it. It is important that we get answers to a lot of questions. Can the Minister tell us who decided that what is happening was okay? Why has there been no public consultation or transparency? Where is the risk assessment? Why were patients not informed that confidential information about their health was being shared with a private company? How much is the company paid for its role? How much has been saved? How many referrals have been cancelled? We need the answers because what is being done is rationing by the back door, with the potential to compromise patient safety.

--- Later in debate ---

[David Mowat]

We are moving around a little bit here, but I will come to the point about consultation. The GP that the hon. Gentleman refers to is a part of a CCG that has made the decision to extend the North Tyneside pilot to North Durham. All I am saying is that those GPs are part of the CCG and that presumably the CCG is doing this because it believes the clinical out-turns are right. We have a locally driven system. I will make some progress on the benefits of this for patients.

[Julie Cooper]

Will the Minister give way?

[David Mowat]

I will make some progress; I have taken a lot of interventions.

The benefits to patients are that a consultant will review their case within two or three days of a GP referral and a decision will be made on the appropriate pathway. That is why the King’s Fund recommended these sorts of systems in 2010—in terms of patient out-turns—and that is why it is of benefit to patients.

One example that the hon. Member for City of Durham talked about was a skin case that resulted in cancer. That is a very serious situation, and if it happened in the way that she says, it should be investigated. Another example is when a patient with acne was referred to a dermatologist at a hospital. The referral system said, “Why have we not tried a cream for this first?” That process was put into place two or three days later, as opposed to having an eight-week wait for a specialist appoint. That is of benefit to the patient.

[Julie Cooper]

Will the Minister give way?

[David Mowat]

I have given way a lot; I want to make some progress.

That is also of benefit to GPs, because they can quickly validate decisions on the best pathway for those grey areas that may or may not require a referral with a consultant who knows more than them about that particular discipline. Of course, it is of benefit to the providers because it takes away something like 20% of unnecessary outpatient appointments. Indeed, one of the providers for the scheme in North Tyneside has asked for it to be extended to an additional discipline, because they feel that some of the referrals they receive are unnecessary and that the referral management system—in the way we have been doing it in the NHS for the past decade—is a mechanism for preventing that.