§ Mr. Georgeasked the Secretary of State for Social Services if he is satisfied with the operation of commercial deputising services for general practitioners; and if he will make a statement.
§ Mr. EnnalsBefore employing a deputising service a family doctor must obtain the consent of the family practitioner committee, which may impose conditions to ensure that the arrangements made are adequate. Family practitioner committees are required by regulations to review periodically, in consultation with local medical committees, the consents given for this purpose, and, if not satisfied with the arrangements, may withdraw their consent or impose different conditions.
My Department has issued guidance to committees as to matters about which they should satisfy themselves in carrying out their statutory duties, in particular that communications are adequate to avoid delays in accepting calls, that the service is under adequate medical supervision, that there is always a doctor available to assess the priority of calls, and that there are enough doctors regularly on duty to deal with normal demand, with a reserve of doctors who may be called upon at short notice when the demand is heavy.
Deputising services were examined in 1973 by a joint working party under the chairmanship of the then Chief Medical Officer of my Department, which had before it detailed studies carried out by the University of Sheffield. While not offering unqualified approval of commercial deputising services, the joint working party believed that they provided support for general practice which might otherwise be lacking in certain areas.
A few formal complaints involving deputising services have on investigation proved to be justified, and although these have been rare in relation to the number of calls with which these services deal, there is evidence of growing concern about the standards of service provided by some deputising services. In their 277W evidence to the Royal Commission on the National Health Service, the Society of Family Practitioners Committees referred to "criticisms and allegations of over-usage or abuse of the services by some doctors or groups of doctors". The representatives of the profession have accepted my view that it would help to ensure higher standards by some if there were a code of practice for all deputising services, amplifying the guidance already given. A revised draft will shortly be submitted for consideration by the General Medical Services Committee and the comments of the Royal College of General Practitioners will also be sought.
It is also my intention to discuss with these bodies whether there are additional steps that can be taken to ensure a higher standard of service.