§ Rev. Martin Smythasked the Secretary of State for Social Services what is the relationship between the fees and allowances paid to doctors for dispensing National Health Service drugs and the costs incurred in providing that service; and what evidence has been given by his Department to the dispensing doctors review body on this matter.
§ Mr. Kenneth ClarkeGeneral medical practitioners as a body are reimbursed all costs incurred providing general medical services including dispensing drugs. Certain of these costs are directly reimbursed which means that each individual doctor receives reimbursement for the costs he personally incurred. Some of these directly reimbursed costs, such as the costs (less discount) of drugs and appliances, relate directly to the cost of dispensing. Others, such as the reimbursement of 70 per cent. of the costs of employing certain ancillary staff and the cost of renting or purchasing practice premises, cover costs incurred providing general medical services and dispensing.
All other costs are reimbursed indirectly on an average basis through fees and allowances. These are set by the review body on doctors' and dentists' remuneration. They cannot build in to each fee and allowance the amount for expenses appropriate to that fee or allowance as this information is not available. It is therefore not possible to say what the relationship is between the payments to doctors for dispensing, which include a dispensing fee and an on-cost addition of 10.5 per cent. of the cost of the item dispensed, and the dispensing costs which they incur.
Our evidence to the review body has in the last two years concentrated on the steps which have been taken to establish the level of discounts obtained by doctors on their drug purchases to ensure that the direct reimbursement of the cost of drugs and appliances as nearly as possible matches the costs incurred.