§ Mr. Hickmetasked the Secretary of State for Social Services (1) if he will list those matters in respect of which general practitioners receive indirect expenses; and if he will quantify the average value of each of the same to individual general practitioners;
what instructions he has given to family practitioner committees in relation to the direct and indirect expenses of part-time general practitioners; and if he will make a statement;
pursuant to his reply of 25 March, Official Report, column 97, and 4 April,Official Report, column 767, if he will list and describe in the fullest reasonable particularity the nature and value of the individual expenses incurred by general practitioners.
§ Mr. Kenneth Clarke[pursuant to his reply, 16 May 1985, c. 214]: The remuneration arrangements are designed to reimburse to general medical practitioners as a body that portion of the expenses they incur which is appropriate to the provision of general medical services. Some of these expenses are paid in whole or in part directly to those incurring them. These include:
Estimated average payment per general practitioner in England in 1984–85 £ 1.Rent and Rates 2,287 2.Ancilliary staff salaries (70 per cent.) and employers NI contributions 4,971 3. GP trainees' salaries and associated costs 1,146 4.The cost of employing locums during sickness, confinement or prolonged study leave 67 5.The cost of drugs and appliances dispensed by doctors 3,965 6. Costs under the doctors' retainer scheme 11 That part of the expenses listed which is not directly reimbursed and all other expenses incurred in providing general medical services are reimbursed indirectly through 142W fees and allowances. These include expenses such as car running costs and other travelling expenses, heating, lighting, postage, medical and surgical supplies and equipment, telephone, stationery, non-structural repairs and maintenance, computers, furnishings, office machinery, salaries of medical assistants, payments to locums other than those employed in circumstances when the direct reimbursement of these costs is appropriate and payments for the use of deputising services.
The total amount of the expenses which are to be reimbursed indirectly is determined from information obtained in confidence from the Inland Revenue for a sample of general medical practitioners and is built into fees and allowances by the Review Body on Doctors and Dentists Remuneration. The review body concluded that on average £10,830 per doctor in Great Britain should be reimbursed indirectly in 1984–85. It is not possible to attribute this to the individual expenses of individual doctors. The average amount paid to doctors in England in 1984–85 through fees and allowances, together with the direct reimbursements listed above and the average improvement grant paid of £138, was £46,280.
The criteria governing the eligibility of general medical practitioners for the direct reimbursement of expenses and the reimbursement of fees and allowances (many of which include an element for expenses not otherwise reimbursed), and where appropriate the rate, are laid down in the "Statement of Fees and Allowances".