§ Mr. Dobsonasked the Secretary of State for Social Services in what circumstances a general practitioner may, on the advice of a consultant, prescribe medicines on the National Health Service to a patient on the general practitioner's list who has seen the consultant privately; and if he will make a statement.
§ Mr. Kenneth ClarkeA general medical practitioner may issue a National Health Service prescription to a patient on his list for any drug which he believes to be clinically necessary and which is available under the National Health Service.
§ Mr. Dobsonasked the Secretary of State for Social Services (1) whether, barring exceptional circumstances, a patient may have a private consultation, followed by free access to National Health Service diagnosis, followed by further private consultations or treatment, in the same medical episode;
(2) in what cirumstances a patient is permitted to transfer from private to National Health Service status for financial reasons;
(3) in what circumstances a patient who undergoes a private operation may receive subsequent treatment or care, in the same medical episode, as a National Health Service patient using National Health Service hospital facilities;
(4) in what circumstances a patient admitted to a National Health Service hospital following deterioration in a private hospital is admitted other than as a private patient, where the National Health Service hospital has private inpatient authorisations and where any quota of pay-beds would not be exceeded thereby.
§ Mr. Kenneth ClarkeOur existing guidance to health authorities in part II of HC(82) 7 states, with respect to resident patients
Patients who enter hospital as private resident patients should not later be allowed to transfer to NHS status except in very exceptional circumstances where the administrator and clinician responsible agree there is evidence of a significant and unforeseen change in circumstances, for example where a patient entering for a minor operation is found to be suffering from a different, more serious complaint.and, with respect to non-resident patients:
Once a patient elects to attend an NHS hospital as a private non-resident patient for a particular medical episode then all services (diagnostic and treatment) used by that patient during that out-patient sequence should be provided on a private patient basis with the appropriate charges being levied. Should exceptionally such a patient, eligible for NHS services, wish to discontinue as a private patient, after consultation then the charge for consultation should be levied and he should seek access to NHS out-patient facilities as an NHS patient in the usual way.There has nevertheless been some confusion about the circumstances in which private patients may change their 566W status to that of National Health Service patients, and we intend to issue revised and consolidated guidance which clarifies this and other aspects of the management of private practice.