Supersurgery revolution put back a year

Pilot schemes for family doctors' "supersurgeries" and perhaps health clinics in supermarkets will be delayed for a year under the NHS Primary Care Bill published yesterday by the Health Secretary, Stephen Dorrell.

The Bill allocates pounds 6m for the preparation of the plans by doctors for expanding their services, but none of the pilot schemes will be given the go-ahead until the next financial year, starting in April 1998.

Although the measure is a flagship for the Tories in the run-up to the election, it signalled the Government will use the extra pounds 500m for the health service to be announced with the Chancellor's Budget next week to avert a crisis this winter in NHS hospitals.

The Independent has learned that Mr Dorrell is expecting hospitals to make ends meet this winter with flexibility over the rules requiring a 6 per cent return on capital.

Mr Dorrell came under fire in the Commons yesterday from Chris Smith, Labour's health spokesman, for the spending crisis facing hospitals this winter, but he ruled out any emergency injection of cash before the end of the year.

It is expected that Mr Dorrell will announce that national pay awards for NHS managers will be held down while more generous pay awards are given to nurses and doctors next year to answer Labour's allegations that the higher spending on the NHS is being swallowed up by bureaucrats.

The health minister, Baroness Cumberledge, and Baroness Jay, the Labour front bench spokeswoman on health, will go "head to head" in the Lords over the Bill, which is due in the Commons in January.

Under the Bill, family doctors will be able to open "supersurgeries" offering NHS patients a wider range of services, including small operations and special care for chronic illnesses such as asthma.

Hospitals will be able to employ GPs for the first time, but there is a power in the bill to allow organisations outside the NHS, which could include supermarkets, to offer primary care on the NHS.

A White Paper to be published next month will pave the way for nurses at practices to do work which is currently reserved for GPs.

The BMA is pushing for GPs to be given a "core contract" with payments for all additional items, but ministers are resisting the idea because of the potential cost.