§ Mr. Bruce George
To ask the Secretary of State for Health (1) for what reasons the management of chronic skin disease was not included within the directed enhanced services of the new general medical services contract; 1548W
(2) for what reason skin diseases were omitted from the new general practitioner contract; and if he will make a statement; [R] 
(3) what input his Department had in deciding the disease areas outlined under clinical domains in the quality framework for the general practitioner contract; [R] 
(4)what factors were taken into account in deciding which disease areas should be included in the general practitioner contract's quality framework and essential services; [R] 
(5) what assessment he has made of how the new general practitioner contract will benefit patients with chronic skin conditions. [R] 
§ Mr. Hutton
No disease is omitted from the new general medical services contract. The legal definition of essential services ensures that skin conditions will continue to be managed and treated in primary care to the extent such conditions can be handled appropriately and effectively in that setting. The contract also provides unprecedented investment in primary care and new mechanisms and opportunities through enhanced services to expand the range of services, improve convenience and choice for patients. This will allow the shift of specialised dermatology services from hospitals to primary care.
The quality and outcomes framework was developed by an independent group of academic general practitioners whose recommendations on which disease areas to include were based on the disease priorities across the United Kingdom, evidence-based practice and accepted national clinical guidelines, and an understanding that responsibility for ongoing management and care of patients rests principally with general practitioners and the primary care team.
The contract was negotiated and agreed by the National Health Service Confederation, acting on behalf of all UK Health Departments, and the British Medical Association.