§ Mr. Knoxasked the Secretary of State for Social Services whether he has now completed his study of the joint Health Departments/British Medical Association inquiry into dispensing doctors' drug costs; and whether he will make a statement.
§ Mr. Kenneth ClarkeThe results of the inquiry have now been analysed. These show that although a minority of doctors do not obtain discounts, the majority do. The discounts obtained amount on average to about 5 per cent. of the cost of all drugs dispensed by dispensing doctors.
260WThe Government and the profession are agreed that, as a matter of principle, the reimbursement of drug costs should as nearly as possible match the amounts actually paid by doctors to their suppliers. Having considered the results of the discount inquiry, they have agreed that the amounts reimbursed to doctors in respect of the costs of drugs and appliances should be abated to reflect the discount received. We will protect the position of doctors with small or remote practices who cannot obtain discounts.
We will be introducing an interim scale from 1 July 1984 at a rate designed to offset over the course of a full year approximately two thirds of the full amount of the discount found from the inquiry. We will introduce a scale to offset discount at the full annual rate in 1985–86.
In practice, the introduction of a discount scale will not reduce the amounts paid to the profession as a whole. To prevent payments falling below the amounts due to doctors in 1984–85 the Doctors' and Dentists' Review Body has been asked to redistribute the amount offset by the discount scale across all fees and allowances paid to all doctors.
Over the course of the next few weeks we shall be discussing with the profession and other interested parties the mechanisms necessary to introduce the discount scale and other consequential changes to the remuneration arrangements for dispensing which it has been agreed with the profession's representatives are desirable.
One such change is the abolition of the option by which dispensing doctors may choose to be reimbursed on a capitation fee basis. The Government and the profession are agreed that this option has outlived its usefulness. Because neither the capitation fee payable in respect of each dispensing patient nor the limit below which capitation fee dispensing doctors have themselves to fund the cost of the drugs they dispense have been raised for many years, the bulk of the cost of drugs dispensed by these 250 doctors is now reimbursed under the drug tariff arrangements. The introduction of a discount scale would lead to some unfairness in the treatment of the two types of dispensing doctor. In the circumstances, we have proposed, and the profession has accepted, that the option to be paid a capitation fee for dispensing should be withdrawn and all payments should be under the drug tariff arrangements from 1 July 1984.