§ Mr. Franksasked the Secretary of State for Social Services if he will now make it his policy to alter the rules 431W governing secretarial payments so as to enable a general practitioner to obtain reimbursement for secretarial work carried out by his wife in the practice.
§ Mr. Kenneth ClarkeThe expenses incurred by general medical practitioners in providing general medical services, including the salaries of ancillary staff, are returned in full to the profession. This includes salaries of dependent relatives. Some expenses are returned direct to individual doctors incurring them and the remainder are returned indirectly, on an average basis, through fees and allowances paid to all GPs.
Seventy per cent. of the salaries of certain ancillary staff are directly reimbursed, but this arrangement has never applied to dependent relatives. A single-handed rural doctor in receipt of a rural practice or inducement payment employing a dependent relative or a doctor employing a dependent relative with a recognised nursing qualification may, however, receive an allowance (currently £1,760) provided the duties performed are qualifying ones. Qualifying duties include secretarial work.
We have followed the policy of successive Governments in deciding that we cannot agree to the inclusion of dependent relatives in the main arrangements for the direct reimbursement of ancillary staff salaries. We have, however, agreed to consider whether changes could be made to the present arrangements, at no additional cost to the taxpayer, in respect of those already covered by the related ancillary staff scheme and at the present level of expenditure incurred.