Mr. Edward M. Taylorasked the Secretary of State for Scotland (1) what arrangements are in operation for the approval of alternative provision for out-of-hours care in general practice in the Health Service; and whether the local health executive councils are satisfied that the emergency treatment at present provides such an adequate alternative service;
(2) what information he has regarding the operation of an emergency treatment service in the Glasgow area; what percentage of the doctors in the area take advantage of the service; how many doctors are normally available in the emergency service to undertake the out-of-hours duties; how many patients they require to cover; and if he is satisfied with the adequacy of the service;
(3) if he is aware of the report submitted by the Glasgow division of the British Medical Association to the national council of that association, a copy of which has been sent to him, conveying their disquiet regarding the operation of the emergency treatment service in the Glasgow area; and if he will instruct the local health executive council to investigate the position.
§ Mr. RossUnder their terms of service, general medical practitioners are required to make all necessary arrangements for securing the treatment of their patients. They must inform the Executive Council of any standing deputising arrangements and remain personally responsible for all acts and omissions of a deputy unless the deputy is himself in contract with the Executive Council. I have recently invited the profession's views on a revision of the terms of service which would make it necessary to obtain the Executive Council's consent before using a deputising service.
The Glasgow Emergency Treatment Service, which is not a National Health Service agency but is sponsored by the British Medical Association, has been in operation since May, 1966 and covers the city of Glasgow and certain adjacent areas. It provides a telephone answering service and an out-of-hours deputising 189W service for general practitioners on payment of annual or monthly fees. I understand that about 45 per cent. of the doctors in Glasgow subscribe to the service, and that 47 doctors have been appointed as deputies. I have no information about the numbers normally on duty or available on call or the number of patients covered at any particular time.
I have read a report of a meeting of the B.M.A. council at which this matter was discussed. There is a statutory procedure for investigating complaints by patients; and one complaint made to Glasgow Executive Council in respect of a deputy provided under the Emergency Treatment Service has been dismissed. I have in addition asked Glasgow and Lanarkshire Executive Councils to consider whether, in general, the deputising arrangements made by general practitioners are adequate.