HC Deb 25 April 1955 vol 540 cc599-601
23. Mr. Hastings

asked the Minister of Health how many general practitioners are engaged in practice under the National Health Service Act, 1946; and how many of these employ assistants.

Miss Homsby-Smith

On 1st July, 1954—the latest date for which figures are available—19,300 general practitioners were practising in the National Health Service. Altogether, 837 doctors, practising single-handed, and 614 partnerships employed assistants, other than trainees.

24. Mr. Hastings

asked the Minister of Health whether in view of the exploitation of assistants by general practitioners under the National Health Service Act which has occurred in certain cases, he will take steps to limit the increased number on a list when an assistant is employed to a maximum of 1,500.

Miss Hornsby-Smith

No, Sir. The relationship of principals and their assistants cannot readily be regulated by Statute. In any event, my right hon. Friend does not think that reducing by 500 the number of additional patients a principal with an assistant might accept on his list would have the effect the hon. Member seems to anticipate.

Mr. Hastings

Does not the Minister realise that many doctors find very great difficulty in getting the necessary capital to start in practice and that they are therefore liable to be exploited by doctors who employ them as assistants? Does not the number which the Minister gave me in answer to my last Question show that there is some evidence of that danger? What does the Minister intend to do about it?

Miss Hornsby-Smith

The number has been decreasing and the number who have been in this position during the period about which the hon. Member asked is not unduly high. The matter is certainly being given consideration by the British Medical Association and the Medical Practitioners' Union, but we have had no decisions or opinions from them on the matter yet.

Mr. Marquand

Does the hon. Lady recollect that it was a definite promise by the medical profession, at the time when the payment of general practitioners was referred to adjudication, that they would seek to reduce the number of assistants and increase the number of principals in practice? Is she satisfied that the medical profession are giving real co-operation in this matter, as they undertook to do?

Miss Hornsby-Smith

There has been an increase in partnerships and a reduction in the number who do a long period as assistants. These consultations are going on between the B.M.A. and the Medical Practitioners' Union, and I think the profession are co-operating in this matter where they feel that there is hardship.

Mr. Hastings

Does the hon. Lady know that the British Medical Association's Committee has already reported, that its report has been published in the B.M.A. Journal and that it is by no means entirely happy about the situation?

25. Mr. Hastings

asked the Minister of Health how many general practitioners or general practitioner partnerships in the National Health Service have employed the same assistant for five or more years.

Miss Hornsby-Smith

My right hon. Friend regrets that information is not available in this form, but on 1st July, 1954, 131 assistants were still in posts which they had taken up before 1st July, 1949.

Mr. Hastings

Does not the hon. Lady think that that is a very serious matter? Even the figures which she has given me show that. While it is admitted that docters may derive a good deal of benefit from being assistants for a time, does not she agree that for them to go on year after year in that position, as these figures suggest, is a very dangerous situation?

Miss Hornsby-Smith

I think we should keep this matter in proportion. On 1st July, 1954, there were 1,504 assistants, and of that number 131 had been in their posts since 1949, as I told the hon. Member. But, on the other side, 320 assistants were taken into partnership during last year and there is a steady increase in the trend towards partnerships.

Mr. Marquand

Would it not be possible to make an inquiry into this comparatively small number of cases to see what the reason is for this long period of assistantship?

Miss Hornsby-Smith

We will certainly consider that point.

Mr. Awbery

Is the number of patients allocated to the assistant laid down by the local committee or by the principal doctor? Is the salary laid down by the local committee or by the doctor who employs the assistants?

Miss Hornsby-Smith

That is laid down in the general terms of contract under the Health Service.