§ Mrs. Renée Shortasked the Secretary of State for Social Services what percentage of patients receiving drugs from their doctor pays prescription charges under the personally administered arrangements ; and what percentage would pay if the same prescriptions were dispensed by a pharmacist.
§ Dr. VaughanUnder paragraph 44. 13 of the statement of fees and allowances governing the remuneration of general practitioners in the National Health Service, a prescribing general practitioner may personally administer to patients certain specified items—currently vaccines, anaesthetics, injections, diagnostic reagents and pessaries. No prescription charges are paid by the patients. Figures of the number of patients to whom items are personally administered under this provision are not available. Whether or not patients would pay such charges if the same items were dispensed by a pharmacist would depend on whether the patient came within an exempted category for prescription charges. Dispensing doctors collect prescription charges from patients for whom they dispense but figures are not available to show what percentage of their dispensing relates to items personally administered under paragraph 44.13.
§ Mrs. Renée Shortasked the Secretary of State for Social Services what are (a) the percentages paid to dispensing doctors in respect of medical practice expenses for premises allowance and ancillary staff allowance, respectively, (b) the additional percentages paid to dispensing doctors in respect of the same premises and ancillary staff which is included in their dispensing remuneration and (c) the net profit margins per prescription paid to dispensing doctors, given that the full cost of premises and 70 per cent. of the cost of the first two ancillary staff have already been reimbursed as medical practice expenses.
§ Dr. VaughanIt is not possible to answer the question in the form requested.
General practitioners receive payments in respect of the practice premises they provide ; in the case of practitioners who dispense, any additional amount paid in respect of accommodation used for dis- 332W pensing is not separately identified. General practitioners may also receive a payment of 70 per cent. of the salaries of ancillary staff, up to a maximum of two whole-time equivalents per doctor engaged on qualifying duties, which can include dispensing duties. These direct reimbursements are notified to the Doctors' and Dentists' Review Body which recommends the level of the fees and allowances, including fees for dispensing, which makes up the remuneration of general practitioners.
The majority of general practitioners who dispense are paid on the drug tariff basis ; this provides for a dispensing fee per prescription, plus a 10½ per cent. on cost payment related to the net ingredient cost of the drugs or other materials they dispense, which is also reimbursed along with VAT paid by the doctor. They also receive a container allowance per prescription. None of these payments includes any specified percentage in respect of premises or ancillary staff costs. It is not possible to give a figure for net profit margin per prescription as information on doctors' dispensing expenses is not collected separately from their other expenses. In its latest report—Cmnd. 7903—the Doctors' and Dentists' Review Body took the view that any double payment to dispensing doctors in respect of ancillary staff employed in dispensing was likely to be minimal.