Tories plan 'super-surgeries' to boost family doctors' role

"Super surgeries" offering patients a range of care by GPs, dentists and visiting consultants, are to be promoted in a new Primary Care Bill in the Autumn by Stephen Dorrell, the Secretary of State for Health.

Mr Dorrell will use the Bill to lay out Tory plans for the expansion of family doctor services if they are returned to power.

It will give the Health Secretary the power to order pilot schemes aimed at widening the range of health care offered by family doctors and drawing more dentists back into the NHS from the private sector.

One model for the future is the South Westminster health centre, in Vincent Square, central London, where two GPs and a dentist combined to give a wide range of "walk-in" services, including X-rays, after the Westminster Hospital closed.

The legislation is intended to build on the Prime Minister's promise to revive cottage hospitals. The aim will be to provide a new generation of "one-stop" clinics where patients may receive a range of treatment close to their homes.

The Primary Care Bill will enable resources to be switched from hospitals to family doctor services, which can be more cost effective. GPs are mainly behind the move, although the BMA is campaigning for GPs to get more pay for more work.

Ministers are prepared to renegotiate the GPs' contract to reward GPs for taking on more work. The Bill will also enable health authorities to hire dentists on contract to deliver care to NHS patients.

Mr Dorrell has told colleagues he wants to encourage dentists to set up practices with GPs. The Health Secretary will use the promise of an expansion of primary care as the centre-piece of his speech to the party conference in the autumn. He has privately said he believes he can capture the high ground on the NHS from the Labour Party's new health spokesman, Chris Smith.

The Bill, which the Tories hope will neutralise Labour claims that they are seeking to privatise the NHS, will be published in draft form after the Queen's Speech on 23 October. It will be proceeded by a White Paper, to enable wide consultation to be carried out before the Bill is enacted.

The Health minister, John Horam, is preparing separate plans to encourage more GPs to seek private finance to expand their NHS surgeries, as part of the Government's private finance initiative (PFI). Under this scheme, new clinics may be financed by private firms and rented by the GPs.

Laing Construction, General Healthcare Group, and BZW have formed a consortium to build a new pounds 170m hospital in Norwich. About 45 smaller PFI schemes have been approved by the NHS, worth more than pounds 160m.

The right-wing Adam Smith Institute yesterday warned in a report that delays and red tape were inhibiting the expansion of private finance for NHS hospitals, public roads and prisons. The report called for "minders" to be appointed to drive PFI schemes forward.

The institute estimated that by the end of 1997, private-sector finance projects in the NHS worth about pounds 1bn would have been presented for approval by ministers. "Each NHS trust seems to be doing its own procurement, pushing for contract clauses that have proved unworkable elsewhere. Meanwhile, the local health authorities and the NHS executive all get involved in decision-making, leading to contra- dictions, confusion and delays."

The report called for full reimbursement for the bidding costs of firms whose projects were cancelled and a limit placed on PFI initiatives to "very few" projects, which are likely to be successful.

r Mr Major said in Chat magazine that he is in favour of alternative medicine and that Mr Dorrell is looking at ways to provide it on the NHS.