§ Sir Barney Hayhoe
To ask the Secretary of State for Health what specific areas of expenditure on the family practitioner services are at present cash limited; which will be cash limited from April 1990; and which he plans to cash limit later.
§ Mr. Kenneth Clarke
At present expenditure on family practitioner services is not subject to a cash limit.
From April 1990, payments to general medical practitioners under the practice staff, cost rent and improvement grant schemes will be subject to a cash limit. From that date, general medical practitioners will for the first time be able to claim direct reimbursement for part of the costs of computer purchase, leasing and maintenance, and these payments will be subject to a cash limit.
A cash limit will apply at national level to total expenditure from GP practice funds which are, subject to parliamentary approval, to be introduced from 1 April 1991. No cash limits will apply to this expenditure at practice level. The management allowance to be paid in relation to the GP funding initiative will be subject to a cash limit.
§ Mr. Hannam
To ask the Secretary of State for Health whether he will commission management studies of the strategic effectiveness of the new National Health Service management structures as they develop, including those where the regional health authority splits into separate businesses, the district health authority secures trust status and certain individual services become trusts.
§ Mrs. Virginia Bottomley
We are supporting a considerable number of development projects designed to test out in districts, hospitals and other units different aspects of our proposed improvements to make sure that workable systems are in place by April 1991. Many of the proposals will evolve throughout the coming decade. We intend to achieve steady incremental progress, informed by the lessons of experience. I see no need to commission management studies at this stage.