My Lords, I will just speak to my Amendments 111 and 168. On Amendment 111, when the noble Baronesses, Lady Brinton and Lady Masham, and the noble and
learned Lord, Lord Mackay, have already put forward the arguments, there is very little for me to say, but the exclusion of the Scottish colleges from the appointment process needs to be rectified. It is an irritant, a hold-up.
In Committee, the noble Lord said that we needed to go through consultation. That was a dreary and negative response. The Scottish colleges have done that. They have consulted and got the support of the Academy of Medical Royal Colleges, NHS Employers and the NHS Confederation. Surely the Minister can just accept this amendment. To simply say that there is no need for it and lots of consultation has to take place is just a ludicrous waste of time and money. This is the time to do it. He should bring an amendment back on Third Reading and be done with it. The noble Lord says that he wants to improve efficiency in the health service. I am afraid I take that with a pinch of salt, because he is just letting officials run riot around him in relation to petty, bureaucratic objections to this change.
Obviously, my other amendment is not major compared to Amendment 80, which is substantial and very important. The noble Baroness, Lady Cumberlege, has really put it forward with great force. Again, I think the noble Lord needs to take a more vigorous approach with the Treasury, because clearly that is where the objection to this is coming from.
My other amendment is about the terrible problem of GP distribution, or the wide variations. I am not going to tempt the noble Baroness, Lady Cumberlege, to come in on the GP issue—but the latest figures, for 31 December 2021, show, for primary care networks in England, the huge variation in the number of GPs. In 24 of the networks, the average list of registered patients for fully qualified full-time equivalent GPs is more than twice the national average. There are five primary care networks where the average is more than three times the national average; these are often in the most deprived areas. No wonder there is an issue of burnout, early retirements and a move to part-time working.
The Government’s response so far is the targeted enhanced recruitment scheme—an incentive for GPs to go into these areas. It is not enough; a much more substantive piece of work is required, and I hope again that the Minister will come forward with a positive response.