§ Mr. Kilroy-Silkasked the Secretary of State for Social Services if he is satisfied with the service provided by general practitioners in the Mersey region, in the light of the high use of deputising services there.
§ Mr. Kenneth ClarkeI expect the family practitioner committees to ensure a high quality of service for their area. The level of consents which they give to use deputising services does not equate with the level of use, on which information is not available centrally. Neither is a necessary reflection on the quality of service provided by general medical practitioners.
§ Mr. Christopher Hawkinsasked the Secretary of State for Social Services (1) if he is now ready to announce what reforms he intends to make of the system of deputising services for doctors;
(2) what proposals he has for monitoring the use by family doctors of deputising services and for ensuring that the standards of those services are satisfactory.
§ Mr. Kenneth ClarkeI have today issued for consultation new draft guidance to family practitioner committees on the use by family doctors of deputising services. The guidance is intended to deal with some shortcomings in existing arrangements which have come to light as a result of my letter of 26 July 1983, to chairmen50W of all family practitioner committees in England, asking them to review their arrangements for consenting to and monitoring the use of deputising services. Everyone accepts the need for the provision of good deputising services to relieve the pressure on doctors in smaller practices. At the same time we have to ensure that the standards of care everywhere are maintained at the high level that the public have come to expect of our family doctor service.
I am therefore proposing the replacement of professional advisory committees which are at the moment responsible for monitoring standards of services, with a sub-committee of the family practitioner committee comprising lay and medical members and responsible directly to the committee for its functions. This will ensure that the FPC is directly involved with protecting the interests of both doctors and patients by checking on the standards of service. Lay members of committees have a part to play here alongside their professional colleagues.
At the same time, I am offering clearer guidance to family practitioner committees on the frequency of use that they should usually expect family doctors to make of deputising services, subject to local circumstances and individual problems. I am also asking for a regular review by the new deputising services sub-committee of standards of services, and an annual review by family practitioner committees of consents to practitioners to use the services, together with some monitoring of frequency of use.
I believe that good deputising services are an essential feature of our family doctor service and that they are providing an excellent standard of care for most patients when they are used. However, the system of controlling them and preventing excessive use of them has not been as good as it might be across the whole country and the time has come to revise our arrangements to bring all services in line with the best.
§ Mr. Meadowcroftasked the Secretary of State for Social Services if he will define the term excessive use as used in his letter of 26 July to family practitioner committees, in the context of doctors' deputising services.
§ Mr. Kenneth ClarkeI had received allegations that some family doctors were using deputising services every night and weekend. I am now issuing, in the light of our review, revising guidance on the extent to which family doctors may be entitled quite properly to use deputising services of the necessary standard to provide a good quality of service to their patients.