GP Fundholding (Hansard, 5 February 1996)

§ Mr. Donohoe
To ask the Secretary of State for Scotland how much has been spent on the management allowances of general practitioner fundholding practices; and how much this represented for each GP fundholder practice in operation in each financial year since the introduction of GP fundholding for each health board area in Scotland. [12505]

§ Lord James Douglas-Hamilton
Expenditure on management allowances for general practitioner fundholding practices in Scotland in the period 1990–91 to 1994–95 is set out in the table. Details of management allowances for individual GP fundholding practices are not held centrally.
85W

GP fundholder management allowance

£000

Health board 1990–91 1991–92 1992–93 1993–94 1994–95

Lanarkshire — — 178 418 535

Lothian 16 33 168 429 697

Orkney — — — — —

Shetland Tayside 4 50 186 283 337

Western Isles — — — — —

Scotland 25 252 1,554 3,114 4,333

¹ Provisional.

§ Mr. Donohoe
To ask the Secretary of State for Scotland what have been at the end of each financial year since the introduction of general practitioner fundholding for each health board area in Scotland the amounts retained by general practitioner fundholding practices. [12507]

§ Lord James Douglas-Hamilton
The information in the table sets out GP fundholder savings which are retained by the health board on the fundholder's behalf to be used for the benefit of patients.

£000

Health board 1991–92 1992–93 1993–94 1994–95

Argyll and Clyde 56 nil 55 214

Ayrshire and Arran — — 330 214

Borders — — 65 291

Dumfries and Galloway — — — 76

Fife — — 96 150

Forth Valley — — 23 101

Grampian 103 95 551 1,207

Greater Glasgow — 13 185 888

Highland — — 87 —

Lanarkshire — — 458 1,360

Lothian 29 39 354 868

Orkney — — — —

Shetland — — — —

Tayside — 12 278 363

Western Isles — — — —

Scotland 188 159 2,482 5,732

§ Mr. Donohoe
To ask the Secretary of State for Scotland what financial support is available to general practitioner fundholding practices from(a) Scottish health boards, (b) his Department and (c) the NHS Management Executive in addition to management allowances paid to general practitioner fundholding practices. [12509]

§ Lord James Douglas-Hamilton
In addition to the management allowance, GP fundholders can receive reimbursement for the purchase of computer systems required for fundholding purposes. This provision allows for GP fundholders to receive 75 per cent. of the cost of computer hardware and 100 per cent. of the cost of the software.

§ Mr. Donohoe
To ask the Secretary of State for Scotland what the maximum level of the management allowances payable to general practitioner fundholding practices has been set at in each financial year since the introduction of fundholding; and what additional expenditure incurred by general practitioner fundholders the management allowances is supposed to cover. [12513]
86W

§ Lord James Douglas-Hamilton
The information requested is set out in the table.

Year Maximum amount of management allowance £

1990–91 16,000

1991–92 33,000

1992–93 34,500

1993–94 35,000

1994–95 35,000

From 1 April 1995:

Standard fundholding practices

£

Fixed standard fundholding allowance (per fund) 27,258

List size allowance per patient for the first 0–6,999 1.88

then 7,000–10,999 1.61

11,000–14,999 1.52

15,000–20,999 1.17

21,000+ 1.02

Site allowance (for each major branch surgery) 650

Standard fundholding group allowance (for each practice in excess of one in a single fund) 1,400

Primary care purchasing practices

£

Fixed primary care purchasing allowance (per fund) 14,135

Site allowance (for each major branch surgery) 650

Standard primary care purchasing group allowance (for each practice in excess of one in a single fund) 1,250

Management expenses are defined in the National Health Service (Fund-Holding Practices) (Scotland) Amendment Regulations 1995 as:

(a) the cost of employing staff in connection with the management of the allotted sum;

(b) the cost of training members of the practice or their staff in connection with the management of the allotted sum;

(c) the cost of either—

(i) employing or engaging (as an assistant or deputy) a registered medical practitioner to provide general medical services to the patients of a member of the practice who is engaged in the management of the allotted sum, or

(ii) paying a member of the practice for his time in connection with the management of the allotted sum;

(d) the cost of acquiring office equipment (excluding computers) required for the purposes of the management of the allotted sum;
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(e) the upkeep and running costs of office equipment required for the purposes of the management of the allotted sum, including computer hardware and software running costs;

(f) the cost of specialist advice required in connection with the management of the allotted sum; and

(g) the cost of minor internal modifications to any premises from which the members of the practice carry on their practice which are required to provide office accommodation for staff employed in connection with the management of the allotted sum.

§ Mr. Donohoe
To ask the Secretary of State for Scotland how much has been retained out of surplus in their budgets by each general practitioner fundholding practice in Scotland at the end of each financial year. [12508]

§ Lord James Douglas-Hamilton
The information requested is not available centrally.

§ Mr. Donohoe
To ask the Secretary of State for Scotland what responsibility health boards and the NHS Management Executive have in respect of monitoring the

1991–92 1992–93

Practices¹ Patients² Percentage of all patients¹ Total¹ Patients² Percentage of all patients³

Argyll and Clyde — — — 1 9,017 2

Ayrshire and Arran — — — — — —

Borders — — — — — —

Dumfries and Galloway — — — — — —

Fife — — — — — —

Forth Valley — — — — — —

Grampian 6 65,656 12.5 6 66,355 12.5

Greater Glasgow — — — 2 20,054 2

Highland — — — — — —

Lanarkshire — — — — — —

Lothian 2 10,649 1.3 2 10,587 1.3

Orkney — — — — — —

Shetland — — — — — —

Tayside 3 19,195 4.7 3 19,432 4.7

Western Isles — — — — — —

1993–94 1994–95

Total¹ Patients² Percentage of all patients³ Total¹ Patients² Percentage of all patients³

Argyll and Clyde 5 36,508 8.2 5 35,996 8.2

Ayrshire and Arran 4 25,479 6.5 5 34,773 8.9

Borders 1 7,003 6.5 3 15,984 14.8

Dumfries and Galloway — — — 1 7,071 4.6

Fife 3 31,274 8.9 4 39,959 11.3

Forth Valley 2 12,390 4.3 4 31,392 10.8

Grampian 26 251,404 46.9 39 332,484 61.7

Greater Glasgow 6 39,208 3.9 13 90,096 9.0

Highland 3 12,218 5.8 7 29,084 13.7

Lanarkshire 9 93,685 16.1 16 174,059 29.8

Lothian 12 78,898 9.8 26 159,457 19.8

Orkney — — — — — —

Shetland — — — — — —

Tayside 10 73,121 17.8 11 83,880 20.4

Western Isles — — — — — —

¹ GP practices which were 'live' fundholders for all or part of the financial year, ie excludes practices in the preparatory stage of fundholding. There were none in the year ended 31 March 1991.

² All patients on the lists of practices, as defined above, including those living outwith the health board area, as at 1 April immediately following the end of the financial year.

³ Patients, as defined above, as a percentage of all patients of all principals contracted to the health board, as at 1 April immediately following the end of the financial year. Includes patients living outwith the health board area and excludes patients who reside in the health board area but are on the lists of principals contracted to other health boards.

88W
use made of general practitioner fundholding practices of any surpluses retained by their practices at the end of the financial year. [12510]

§ Lord James Douglas-Hamilton
Under the National Health Service (Fundholding Practices) (Scotland) Amendment Regulations 1995, it is the responsibility of health boards to be satisfied that expenditure by GP fundholders on audited savings is for the benefit of the patients of the members of practice and represents value for money.

§ Mr. Donohoe
To ask the Secretary of State for Scotland how many general practitioner fundholding practices have been in operation, giving the number of patients covered by general practitioner fundholding practices; and what percentage this represented of the health board's total population for each financial year since the introduction of general practitioner fundholding for each health board area in Scotland. [12506]

§ Lord James Douglas-Hamilton
The information requested is set out in the table:

GP fundholder management allowance
£000
Health board	1990–91	1991–92	1992–93	1993–94	1994–95
Lanarkshire	—	—	178	418	535
Lothian	16	33	168	429	697
Orkney	—	—	—	—	—
Shetland Tayside	4	50	186	283	337
Western Isles	—	—	—	—	—
Scotland	25	252	1,554	3,114	4,333
¹ Provisional.

Year	Maximum amount of management allowance £
1990–91	16,000
1991–92	33,000
1992–93	34,500
1993–94	35,000
1994–95	35,000

Standard fundholding practices
	£
Fixed standard fundholding allowance (per fund)	27,258
List size allowance per patient for the first 0–6,999	1.88
then 7,000–10,999	1.61
11,000–14,999	1.52
15,000–20,999	1.17
21,000+	1.02
Site allowance (for each major branch surgery)	650
Standard fundholding group allowance (for each practice in excess of one in a single fund)	1,400

Primary care purchasing practices
	£
Fixed primary care purchasing allowance (per fund)	14,135
Site allowance (for each major branch surgery)	650
Standard primary care purchasing group allowance (for each practice in excess of one in a single fund)	1,250

	1991–92	1992–93
	Practices¹	Patients²	Percentage of all patients¹	Total¹	Patients²	Percentage of all patients³
Argyll and Clyde	—	—	—	1	9,017	2
Ayrshire and Arran	—	—	—	—	—	—
Borders	—	—	—	—	—	—
Dumfries and Galloway	—	—	—	—	—	—
Fife	—	—	—	—	—	—
Forth Valley	—	—	—	—	—	—
Grampian	6	65,656	12.5	6	66,355	12.5
Greater Glasgow	—	—	—	2	20,054	2
Highland	—	—	—	—	—	—
Lanarkshire	—	—	—	—	—	—
Lothian	2	10,649	1.3	2	10,587	1.3
Orkney	—	—	—	—	—	—
Shetland	—	—	—	—	—	—
Tayside	3	19,195	4.7	3	19,432	4.7
Western Isles	—	—	—	—	—	—