HL Deb 09 December 1991 vol 533 cc23-4WA
The Countess of Mar

asked Her Majesty's Government:

What proportion of NHS general practitioners' net remuneration in England and Wales is allocated to expenses incurred under Regulation 29(a) of Statutory Instrument No. 313, 1983; and what proportion of that allocation is for the purchase of emergency drugs, dressings and appliances; and

Whether they will consider extending the list of drugs, dressings and appliances for which prescribing doctors may be reimbursed under paragraph 44.5 of the "statement of fees and allowances" to enable prescribing doctors to provide emergency treatment in line with dispensing doctors and doctors in Scotland; and

Whether they will consider reimbursing all general practitioners for the actual cost of drugs, dressings and appliances used for emergency treatment in order to encourage general practitioners to provide such items, thereby improving their service to patients and reducing referrals to hospital casualty departments; and

Whether in the Department of Health's booklet (reference 1445M/91–155) the lack of any mention of Schedule 1, paragraph 35, to the National Health Service (General Medical and Pharmaceutical Services) Regulations 1974, Schedule 1–3 as amended, means that NHS general practitioners are no longer expected to provide their patients with emergency treatment.

Baroness Hooper

Regulation 29B(a) (formerly Schedule 1, paragraph 35) of the NHS (General Medical and Pharmaceutical Services) Regulations 1974 obliges a GP to supply a drug or appliance to his patient where such supply is needed for the immediate treatment of that patient before a supply can be otherwise obtained. Regulation 29B(b) permits a GP to supply to his patients a drug or appliance which he personally administers or applies to that patient rather than arrange the supply by ordering the item on a prescription form.

Paragraph 44.5 of the Statement of Fees and Allowances provides for GPs to be directly reimbursed the costs of personally administering certain listed drugs, which include vaccines, anaesthet-ics and injections. Any expenses which a GP incurs in supplying and/or personally administering an item for which no direct reimbursement is available are reimbursed indirectly through the fees and allowances paid to the profession as a whole. It is not possible to identify separately the expenses incurred by GPs under circumstances covered by Regulation 29B(a).

There are many competing claims on resources for the family health services and we have no immediate plans to broaden the scope of paragraph 44.5 and increase the range of personally administered items for which direct reimbursement is available.

General practitioners are required by their terms of service to provide their NHS patients with all necessary and appropriate personal medical services. This includes treatment required in an emergency.