§ Mr. Wrigglesworthasked the Secretary of State for Social Services if she has any evidence of a decline in the use of family planning clinics run by local authorities since she removed the prescription charge on contraceptives.
§ Dr. OwenFamily planning clinics which had been the responsibility of local authorities up to 1st April 1974 were on that date transferred to the health authorities under the National Health Service. At the same time the Government decided not to impose a prescription charge on contraceptives prescribed and dispensed by clinics.
Although the latest figures available of attendances at NHS family planning clinics, which are for the last nine months of 1974, are not exactly comparable with those of 1973, they do show that there was an increase in the use of the clinic service after 1st April 1974, which may have been due in part to the absence of a parallel free service in general practice.
282WFigures for attendance at family planning clinics since the introduction of the free general practitioner family planning service on 1st July 1975 are not yet available.
§ Mr. Wrigglesworthasked the Secretary of State for Social Services if she will introduce regulations to make it necessary for all doctors fully to examine patients before prescribing contraceptives.
§ Dr. OwenNo. The nature of any examination needed to be carried out by a doctor before prescribing treatment of any kind is a matter of clinical judgment.
§ Mr. Wrigglesworthasked the Secretary of State for Social Services (1) what family planning training a general practioner requires before providing family planning services for patients;
(2) what family planning training a doctor providing family planning services in a local authority clinic requires before providing services for patients.
§ Dr. OwenIt is for the general practitioner, as an independent contractor, to satisfy himself that he has adequate training and experience for any service he gives. The Department has circulated to all general practitioners the "Handbook of Contraceptive Practice" prepared for the Standing Medical Advisory Committee which refers to the need for suitable training. Practitioners have to state when claiming fees that in giving the services they have been guided by modern authoritative medical opinion such as the advice given in the handbook.
It is for the NHS authorities which took over family planning clinics from local authorities on 1st April 1974 to decide when appointing doctors to them whether their previous experience and training are appropriate to these duties. The advice issued by the Department to Health Authorities in May 1974 in the Family Planning Service Memorandum of Guidance was that the professional staff—doctors and nurses—working at family planning clinics should have received special family planning training in addition to that received in their pre-qualification courses.
Courses on family planning have been available through Post-Graduate Deans and voluntary bodies for some years and 283W many doctors, including general practitioners, have attended them. The funds the Department is providing to health authorities to develop their family planning courses cover the training of general practitioners.
§ Mr. Wrigglesworthasked the Secretary of State for Social Services what scales of fees are paid to doctors providing family planning services in local authority clinics.
§ Dr. OwenAll local authority family planning clinics were transferred to the National Health Service at the time of reorganisation last year. The fees paid for the work varied between authorities, and transferred doctors continued to be paid on their previous rates. Rates have since been increased, and those which apply in many clinics are currently as follows:
Sessional Fees from 1.4.75 £ Ordinary Birth Control Session full session 11.31 short session 7.32 clinical assistant 7 61 Consultants full session 16.54 short session 10.80 Instructing Doctors—All Methods (including IUD) when a trainee is present or intended to be present 14.33 Ordinary IUD Session full session 13.71 short session 8.62 Marital Difficulties Session full session 13.71 short session 12.61 Subfertility Session 13.71 Research Session 13.71 Mixed Birth Control/IUD Session 12.61 Vasectomy Session Surgeon 27.39 Registrar 18.27 Interviewing doctor 11.31 Domiciliary Long Visit (over ¼ hour) 2.90 Short Visit (under ¼ hour) 1.45 Unproductive visit 0.94 Staff transferred on more favourable rates continue to receive them.