Family Doctors (Hansard, 16 October 1990)

§ Mr. Hardy
To ask the Secretary of State for Health if he will take steps to ensure that the reimbursement rate for the cost of baby sitters whose employment is necessary to allow a family doctor to attend to his patients is set at a level which takes account of the prevailing level of charges made for such services.

§ Mrs. Virginia Bottomley
No specific payment can be claimed by a family doctor for employing a baby sitter.

§ Mr. Hardy
To ask the Secretary of State for Health what is his estimate of the hourly cost of employment of a locum to assist or to substitute for a family practitioner; and if the cost is fully reflected in the financial arrangements made by his Department.

§ Mrs. Virginia Bottomley
As independent contractors, general medical practitioners make their own arrangements for locum cover. Where a locum is employed due to specific circumstances such as sickness or confinement, family health services authorities may make a direct contribution to the cost of a locum up to £328 for a five-day week. Similar payments can be made in certain circumstances where the GP is absent from the practice for educational purposes. Locum costs in addition to this direct payment, or incurred for reasons unconnected with the circumstances described above, are reimbursed indirectly through the generality of fees and allowances payable in respect of all patients on the GP's list. By these means all locum costs are reimbursed to the profession.

§ Mr. Hardy
To ask the Secretary of State for Health if allowances and capitation fees paid to family doctors under the new arrangements are more or less than the previous out-of-hours allowances.

§ Mrs. Virginia Bottomley
The only fee payable for out-of-hours services is the night visit fee. Since April 1990, this fee has been split into two with a much higher fee—£43.35 compared to £20.25—payable if the family doctor does the visit himself and a lower fee—£14.45—payable if a deputising service doctor makes the visit. This change was made as part of the performance-related pay introduced under the new contract.
Before April 1990 supplementary capitation fees and a supplementary basic practice allowance were paid for 794W out-of-hours services. These have been abolished and the money redistributed amongst other fees and allowances, in particular by way of capitation fees. These have gone up by some 30 per cent. for patients under 75 and by some 110 per cent. for patients aged 75 and over.

§ Mr. Hardy
To ask the Secretary of State for Health what reimbursement is permitted for family doctors for service between 7 and 10 pm in weekdays or during the period to 10 pm on Saturdays, Sundays and bank holidays.

§ Mrs. Virginia Bottomley
Family doctors are responsible for their patients 24 hours a day for seven days a week. In recognition of this responsibility family doctors receive a capitation fee for each patient on their NHS list. This amounts to £11.95 per annum for each patient under 65, £15.75 per annum for each patient aged 65 to 74 and £30.35 for each patient aged 75 and over. These amounts are to be increased, from 1 January 1991, to £12.40, £16.30 and £31.45 respectively. Home visits between the hours of 10 pm and 8 am attract additional payments of £43.35—£45 from 1 January 1991—if the doctor undertakes the visit himself or the visit is made by another doctor in the same group, and £14.45—£15 from 1 January 1991–if a deputising service doctor makes a visit.