§ Mrs. FyfeTo ask the Secretary of State for Scotland if he will describe the financial policies by which non-fund-holding practices obtain or employ(a) drugs, medicines and listed appliances, (b) goods and services, (c) services carried out by a member of the practice such as those listed in schedule 3 to S.I. 1993 No. 488 (S.53), (d) employees of members of the practice employed to provide treatment or manage/administer the practice and (e) purchase of materials, equipment, or improvement of the premises.
§ Mr. StewartThe costs incurred by non-fund-holding practices under these headings are met by the health board either from within their financial allocations or in the case of drugs, medicines and listed appliances by drawing on NHS resources held centrally.
Those services listed in schedule 3 to S.I. No. 488 (S.53) cannot be carried out by a member of a non-fund-holding practice, but instead may be obtained by referral to a provider unit with the costs being met by the health board.
§ Mrs. FyfeTo ask the Secretary of State for Scotland if he will make it his policy to ensure that non-fund-holding practices will be able to offer services in every respect equal to those that become fund-holding practices.
§ Mr. StewartAll the patient care services currently included within the scope of the GP fund-holding scheme are also available to non-fund-holding practices. GP fund holders have the flexibility to use their fund to provide these services or purchase them from other providers for the benefit of their patients. The Government's framework for the GP fund-holding scheme seeks to maintain a proper balance between providing GP fund holders with an appropriate degree of flexibility in the use of their fund and preserving the principle of equity of access to health care for all NHS patients. GP fund holders, in providing care themselves or in setting contracts with other providers, will be able to develop improved standards in the quality of care for their patients provided as a consequence they do not directly disadvantage NHS patients from other practices.
§ Mrs. FyfeTo ask the Secretary of State for Scotland what estimate he has made of the average outturn surplus at the end of the first year of operation of fund-holding practices.
§ Mr. StewartDuring 1991–92, their first operational year, GP fund holders in Scotland by careful management of their funds achieved average savings, following audit, of 409W around 4 per cent. A proportion of these savings was returned to the health boards, leaving fund-holder practices with total savings of £190,000. These savings may only be applied in accordance with regulations, and with health board agreement, for the benefit of the fund-holders' patients and do not represent income for the GPs and practices involved.