The Government initiated the debate in the hope of exposing Labour's attitude to fundholding as "hypocrisy" - advocating choice and diversity yet opposing it for family doctors. The fact that Harriet Harman, as the shadow Secretary of State for Health, would have to speak from the despatch box looked like a further plus and Mr Dorrell made much of her "opting the Harman family out of the politically correct" education while taking an "absolutist" stand on the NHS.
However, he was thrown on to the defensive by evidence of waiting time disparities quoted to the Commons by Ms Harman from an internal bulletin of the Central Sheffield University Hospitals Trust. For cardiology treatment, the patients of non-fundholding GPs were waiting 26 weeks for an out-patient appointment compared to a 12-week wait for those of fundholders. For dermatology the difference was 26 weeks to 9, and for neurosurgery 23 weeks to 9. "A two-tier system is an inevitable part of GP fundholding," Ms Harman said. "Some patients are fast-tracking for hospital appointments. Others have to wait longer."
Mr Dorrell said fundholders were making choices about the use of resources. But while this allowed them to improve the NHS care available to their patients, it was not done on the basis of any unfair allocation of resources. "What Ms Harman is doing is highlighting how fundholders are making progress with standards which then lead to pressure for improvements right across the board."
Ms Harman said it was not GP fundholders who were doing the operations but the hospitals. Instead of looking at who was funding the operation, hospitals should be looking at who was in the greatest pain. In Sheffield hospitals, patients of non-fundholders had to wait 52 weeks for hip replacements while those of fundholders only waited up to three months, even if their condition was less serious. "The Secretary of State in this debate has just endorsed the two-tier system."
Despite all the advance publicity, a Tory MP's Bill to curb the sexual contents of teenage girls' magazines appeared destined for the legislative graveyard last night after it emerged the Government will not support it.
However, Tom Sackville, the Under-Secretary for Health, said outside the chamber that he would be discussing concerns about the magazines with publishers and retailers and the issue would also be considered by the Inter-Departmental Group on Obscenity.
Introducing his Periodicals (Protection of Children) Bill, Peter Luff, MP for Worcester and father of two - including an 11-year-old daughter - told MPs the Bill would require publishers to display the youngest recommended reading age on the cover, an approach considered "impractical" by ministers.
"These magazines undermine the value and importance of sex," he said. They included details of how to perform oral sex and rock stars' boasts of losing their virginity at an early age. "Although children may be physically mature rather younger, that's not necessarily true that they are emotionally mature any sooner."
Mr Luff told MPs they should just look at the covers: "Sex and You, read our sealed section now; Men Unzipped, an intimate guide to men's minds and bodies; Red Hot Sizzling Male Model - Posters Inside; I had sex with my ex but was forgiven; Boys in the Buff, shot so hot we seal the pages; First-Time Sex, how to get it right."Reuse content