§ 13. Mr. Ian BruceTo ask the Secretary of State for Health what progress is being made in spreading the effects of the GP fund-holding initiative in Dorset to patients of GPs who are not fund holders.
§ Dr. MawhinneyGeneral practitioner fund holders are achieving real benefits for their patients by innovative and sensitive purchasing of health care. District health authorities can reflect the standards set by fund holders in contracting for the patients of other GPs. In Dorset this is being achieved through the Dorset Health Commission, set up by the Wessex regional health authority, which is taking account of all GP's views, including fund holders, in developing purchasing plans.
§ 18. Mr. KnapmanTo ask the Secretary of State for Health what plans she has to extend the GP fund-holding scheme to smaller practices.
§ Dr. MawhinneyThe minimum list size criteria for general practitioner fund holders is being lowered from 9.000 to 7,000 from 1 April 1993. We are enabling smaller practices to join either by linking with another practice, or through an agency arrangement with their local family health services authority or district health authority.
§ 21. Mr. GrocottTo ask the Secretary of State for Health what steps she is taking to ensure that patients on waiting lists of fund-holding and non-fundholding GPs are treated equally.
§ Dr. MawhinneyGuidance agreed with the joint consultants committee was issued to hospital consultants in June 1991. It set out the criteria for contracts between general practitioner fund holders and all national health service hospitals, and clearly states that common waiting lists should be used and the fund holders should not he offered contracts which would disadvantage other patients.
§ 23. Mr. HunterTo ask the Secretary of State for Health what assessment has been made of how GPs' interest in the fund-holding initiative has changed since the scheme began.
§ Dr. MawhinneyI refer my hon. Friend to my reply to my hon. Friend the Member for Faversham (Sir R. Moate) earlier today.
§ Mr. MilburnTo ask the Secretary of State for Health what was the 1992–93 budget allocation by region and family health service authority for hospital costs generated by general practitioner non-fund holders for those parts of the hospital and community health services that a general practitioner fund holder would have had allocated funds.
§ Dr. MawhinneyRegions give allocations to district health authorities on the basis of their resident population and not in relation to the number of non-fundholding general practitioners within the district. Furthermore532W district health authorities and family health services authorities are not usually coterminous. Information is not therefore available in the form requested.
§ Mr. MilburnTo ask the Secretary of State for Health, pursuant to her answer of 11 February,Official Report, column 752, what steps she has taken to ensure that the joint guidance issued to hospital consultants on general practitioner fund holding is being properly enforced; and if she will make a statement.
§ Dr. MawhinneyWe remain committed to the principles set out in the guidance. Providers should not offer contracts to one purchaser which would disadvantage the patients of another, and common waiting lists should apply for urgent and serious conditions. Equally, we stand by the principle that purchasers, both fund holders and district health authorities, should be able to purchase spare capacity if this becomes available. Regional health authorities are responsible for monitoring compliance with the guidance.
§ Ms PrimaroloTo ask the Secretary of State for Health further to her answer of 17 February,Official Report, column 203, what reasons underlie the different treatment of general practitioner fund holders and non-fund holders for sessions for tests and minor surgery.
§ Dr. MawhinneyFundholding and non-fundholding general practitioners are not being treated differently. Regulations have been changed to allow fund holders to receive remuneration from the fund for treating their own patients, putting them in the same position as non-fund holders, who may already provide these services under contract to district health authorities.
§ Mr. MilburnTo ask the Secretary of State for Health if she will list by region the allocation, for general practitioner fund holders in 1992–93, for prescribing.
§ Dr. MawhinneyThe information requested is in the table.
GP fund holder prescribing budgets, England 1992–93 First and second wave fundholders combined, in actual cost Region £ Million Northern 26.1 Yorkshire 40.1 Trent 33.5 East Anglian 9.2 North West Thames 21.9 North East Thames 10.4 South East Thames 15.7 South West Thames 20 1 Wessex 21.8 Oxford 26.6 South Western 22.3 West Midlands 34.6 Mersey 26.7 North Western 19.3