HC Deb 28 November 1989 vol 162 cc220-1W
Mr. Vaz

To ask the Secretary of State for Health how many representations he has received from general practitioners regarding the new contracts; and if he will make a statement.

Mrs. Virginia Bottomley

Since the publication of "The 1990 Contract" on 3 August 1989, the Department has received over 800 letters on the subject, mostly from general practitioners. The regulations necessary to introduce the new contract were laid on 16 October arid have been approved by Parliament. All GPs will shortly be receiving their new terms of service and the revised statement of their NHS fees and allowances. The new arrangements will come into operation from 1 April 1990.

Mr. Vaz

To ask the Secretary of State for Health if he will make a statement regarding budgeting levels for regional health authorities and family practitioner committees in relation to the Government White Paper.

Mrs. Virginia Bottomley

We have announced that, following this year's public expenditure survey, an additional £257 million will be made available in the NHS as a whole in England in 1990–91 for initiatives arising from the White Paper "Working for Patients". This brings the total available for regional health authorities and family practitioner committees in England next year for implementing the White Paper to £300 million. This is part of the extra £2.6 billion resources that the NHS in the United Kingdom will have available next year, £2.2 billion of which will be for England.

Mr. Latham

To ask the Secretary of State for Health to what extent he intends that general practitioners who are not budget holders will be permitted to choose the hospital to which they send their patients for(a) non-emergency treatment on an inpatient basis and (b) maternity care, including delivery of the baby; and whether he will make a statement.

Mrs. Virginia Bottomley

For all services, including non-emergency and maternity services, GPs should usually be able to choose the hospital that they consider most appropriate, taking account of their patients' needs and wishes. GPs who are not fund-holders will normally refer patients to hospitals with which the district health authority (DHA) has placed contracts. In placing those contracts the DHA will be expected to secure the referral patterns which local GPs wish to see put in place, unless there are compelling reasons for not doing so. In addition, the DHA will maintain a financial reserve to cover those occasions when GPs need to refer patients to hospitals with which their DHA has not contracted.

Mr. Latham

To ask the Secretary of State for Health what arrangements will be made in relation to the assessment of the unit costs of small local community hospitals in the event of budget-holding general practitioners seeking to place their patients in larger hospitals with lower unit costs; and whether he will make a statement.

Mrs. Virginia Bottomley

We will be issuing guidance next year on the costing of hospital services in respect of the operation of general practice fund holding.