Tax-cuts battle hits Dorrell's GP plans

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The Independent Online
Publication of a White Paper on the future of family doctor services has been delayed by a battle between Stephen Dorrell, Secretary of State for Health, and the Treasury over the cost of the plans.

The public-spending battle has been suspended for the party conference, but the struggle for reductions to make room for tax cuts in next month's Budget will be restarted next week by Kenneth Clarke.

The Chancellor, who addresses the conference tomorrow, will chair the meeting of the Cabinet EDX committee on public expenditure to thrash out the final savings on the pounds 262.8bn budget allocated for next year.

The BSE crisis has caused a sharp rise in spending, virtually wiping out the contingency reserve for this year, but the Chancellor is keeping a tight rein on spending commitments at the conference.

Mr Dorrell yesterday was unable to give any firm date for the White Paper but confirmed that legislation to expand family doctor services would be in the next Queen's Speech.

The Treasury is anxious to ensure that the expansion of the family doctor services will be cost-effective. The White Paper will precede the legislation under which there will be pilot schemes allowing GPs to offer a wider range of services, more consultants to hold clinics in GP surgeries, and hospitals to employ GPs where there is a local need.

Mr Dorrell also confirmed that he is postponing until after the general election the scheme to spare the elderly being forced to sell their homes to pay for long-term care.

The Prime Minister had given a pledge to defuse a row over the issue among Tory supporters. Mr Dorrell produced a "partnership" plan to enable the elderly to keep capital assets if they took out insurance long-term care.

Mr Dorrell last night confirmed that the legislation will be published in draft form next month, and it will not be enacted until after the election. "It would be a great mistake to introduce legislation on a complex set of issues without having ensured it is right," he said. "The right way forward for that legislation is to publish a Bill in draft."

The Health Secretary yesterday also faced open criticism of the failure of care-in-the-community services.

Doing away with a conventional conference speech, Mr Dorrell held an hour-long question-and-answer session and faced repeated demands for action to end "bed blocking" by elderly patients who cannot be released from hospital because there is no place for them in the community.

Leaders of the Conservative Medical Society, normally guaranteed to offer friendly questions, highlighted the deep concern in the NHS at the numbers of elderly people who are occupying hospital beds because the social services departments have failed to provide care-in-the-community places for them.