Norman Lamb speaks for the Liberal Democrats during a debate on family doctor services

Liberal Democrat Shadow Health Secretary, Norman Lamb, focused on the importance of local accountability in health services and the problems created as a result of Labour and the Conservatives’ emphasis on central control and unelected quangos.

On the lack of accountability among primary care trusts to the communities that they serve Norman Lamb said:

“I was fascinated when the Secretary of State again tantalisingly indicated his recognition of the lack of accountability among primary care trusts to the communities that they serve, while the Conservatives rejected any change to the accountability of primary care trusts. May I commend to the Secretary of State the Liberal Democrats’ proposals to democratise the commissioning of health care? Primary care trust boards should be elected, not appointed nationally. Ultimately, the Conservatives want to retain the central model of control of the NHS. The Secretary of State suggested that he recognised the case that we had made, but will he go the whole way and provide proper accountability to the communities that trusts serve? We wait to see what his announcement amounts to.”

On the difference between polyclinics and health centres Mr Lamb said:

“This afternoon’s discussion on the difference between a polyclinic and a health centre was interesting. As I said at the NHS Confederation briefing yesterday, the honest truth is that the difference amounts only to a rebadging. The Government were calling these bodies polyclinics, but they got such a bad name through what GPs and others said about them that we now call them something else. When I asked what a GP-led health centre was all about, all the things that I was told they would contain sounded very much like a polyclinic. These are, at the very least, embryonic polyclinics.”

On central imposition of GP-led health centres Mr Lamb said:

“We know that there is a central imposition of a GP-led health centre in every primary care trust. There is no option; all trusts have to introduce them. I had discussions with the East of England strategic health authority, which made it clear that every PCT must have such a centre. In the case of Norfolk, for example, I was told by the GPs I met last week that the PCT has not yet even completed its review of its estate - the buildings it owns - to ensure that it makes the most effective use of that estate. Suddenly, however, because the Government told the trust to do so, it has stopped doing that work and is now having to focus on the introduction of a polyclinic - sorry, a health centre - in Norwich.”

On the eventual loss of local GP surgeries and accountability Mr Lamb said:

“One legitimate concern is the eventual loss of the network of local GP surgeries, about which many people will be very anxious. If this kind of model is to be adopted, I think that a rural community hospital should be used as a basis for the development of such an extended range of services. We in Norfolk are in a ludicrous position. We face the loss of a community hospital in Aylsham, a market town, and we are seeing the loss of beds in other community hospitals. Surely we should develop existing, trusted centres of excellence and take the consultants out of acute hospitals, ending the divide between primary and secondary care and providing genuine local care for those who need it.

“I want to say a word about the Conservatives. I think there is a degree of hypocrisy in their complaint about central control. They have conveyed the clear message that they dislike the degree of central control exercised by the present Government, yet they propose to introduce a CSA-style unaccountable quango, presumably based in London, to direct the national health service. The Child Support Agency is rather unpopular, and I suspect that when people find that their local hospital is to be closed by a centralised unaccountable quango in London, they will regard it much as they regard the CSA. There is no democratic local accountability in that, and the Conservatives know it. They reject this model, and decide instead to retain the idea of a centralised system. That is even worse than the Government’s approach, which at least involves some democratic input in the House.”

On the Government’s emphasis on central control Mr Lamb said:

“The motion is right to address the Government’s excessive emphasis on central control. I challenge the Government to provide genuine accountability for local communities, as the Liberal Democrats propose. I also urge the Secretary of State to listen to the concerns of general practitioners. The model that we should choose is democratic local accountability on the shape of health services serving a community. Alongside that, we should free up GPs and health professionals to do the job that they are qualified to do without overly controlling them from Whitehall.”

The Conservative motion was defeated, with 211 voting for and 306 voting against
The Liberal Democrats voted in favour of the motion
Click here to read Norman Lamb’s speech in full