§ The Prime Minister
The text of a letter from the Chairman of the Review Body is reproduced below. The Government confirm their acceptance of the Review Body's recommendations, as now clarified. My right hon. Friends the Minister of Health and the Secretary of State for Scotland will consult the medical profession's representatives about how the recommended increase in the net remuneration of general practitioners, estimated to amount in total to an additional £5frac12; million a year, should be distributed in the light of this clarification
Following is the letter:
Review Body on Doctors' and Dentists' Remuneration
We have been asked to state our intentions with respect to the effect of our Fifth Report, in the event of the medical profession being unable to agree to the schemes for direct reimbursement of certain practice expenses.
2. In that Report we recommended inter alia that:
- (1) in 1965–66 and subsequent years payments to general medical practitioners by hospital authorities, local authorities and Government departments should be excluded from the pool and average net income for purposes of the pool calculation should relate to all the services for which payments are made to general practitioners by Executive Councils;
- (2) from 1st April, 1965, the average net income for Executive Council services credited to the pool for every principal under the age of seventy providing unrestricted general medical services should be £2,775;
- (3) the additional money which these recommendations would make available in the pool should be drawn upon so far as necessary to make possible the introduction of schemes for the partial direct reimbursement to individual doctors of expenditure on ancillary help and on practice premises.
3 When we took the evidence on which our Fifth Report was based, we were informed that:
- (1) a scheme had been agreed in principle between the Health departments and the profession's representatives for reimbursement direct to individual doctors of
231 about two-thirds of their expenditure on ancillary help, and
- (2) a fairer distribution of total reimbursements of expenditure on practice premises was agreed to be desirable and consideration was being given to a scheme for contributing direct to the expenses of individual doctors who incurred relatively heavy costs on practice premises.
4. The third of the recommendations set out in paragraph 2 was made on the assumption—indeed in the hope—that schemes would be agreed by the profession for introduction on 1st April, 1965. If the schemes were not introduced, that recommendation could not take effect. All the other recommendations contained in our Fifth Report would stand.
5. We should, however, deplore it if the schemes for partial direct reimbursement were not introduced. We consider that these schemes would encourage doctors to employ more ancillary staff and would help those who use good practice premises, by adding to the gross remuneration of those who do so. Thus the schemes would be in the best interest of the profession and of patients. We see no practicable method, other than the one we proposed, of introducing these schemes without either overdrawing the pool or asking doctors to forgo the final distribution of earlier pool balances and committing future pools or reducing capitation fees.