Doctors (Hansard, 16 May 1985)

§ Mr. Hickmet
asked 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;
(2) 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.
(3) 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
I shall let my hon. Friend have replies as soon as possible.

§ Mr. Hickmet
asked the Secretary of State for Social Services what are the maximum fixed expenses for which general practitioners are eligible under section 63 of the National Health Service Act 1977; and if he will list the same.

§ Mr. Kenneth Clarke
I shall let my hon. Friend have a reply as soon as possible.
215W

§ Mr. Hickmet
asked the Secretary of State for Social Services what is the top rate seniority allowance for general practitioners; what is the eligibility of older general practitioners to obtain further superannuation; at what age such incentives commence and cease; and what is the effect on the eligibility of general practitioners for such incentives if they obtain limited commitment.

§ Mr. Kenneth Clarke
The top rate seniority allowance for general medical practitioners is currently £4,375 per annum. A lower allowance first becomes payable after 11 years on the medical register and seven years as a National Health Service principal. Seniority allowance ceases to be payable at age 72. Payment of the allowance to a doctor who has a limited commitment depends on the nature of the commitment.
General practitioners may retire at any time on reaching age 60. If they retire and again practise, even after 24 hours, as principals in the National Health Service, any pension payable will be reduced so that post-retirement earnings plus pension do not exceed pre-retirement earnings. While re-employed, retired doctors continue to pay contributions to the NHS superannuation scheme and earn further pension rights up to age 70. However, general practitioners who retire for the first time at age 65 or over may be re-employed without their pension being liable to reduction. In such a case, the re-employment is not superannuable and no further pension rights may be earned.

§ Mr. Hickmet
asked the Secretary of State for Social Services if he will identify and list, together with the sums payable in respect of each, the basic allowances, seniority allowances and other fees or allowances for which general practitioners are eligible

§ Mr. Kenneth Clarke
The fees and allowances, together with the rates payable at 1 November 1984, are as follows:

Rates at 1 November 1984 £

1. Basic Practice Allowance:

(a) Full rate 6,760 per annum

(b) First 100 patients 1,360 per annum

(c) Each patient above 100 to 999 6 . 00 per annum

(d) Leave payment 1,352 per annum

2. Additions to Basic Practice Allowance in respect of:

(i) Pratice in a designated area

Type 1 2,095 per annum

Type 2 3,195 per annum

(ii) Practice as a member of a group 1,175 per annum

(iii) Seniority

First payment 1,620 per annum

Second payment 2,760 per annum

Third payment 4,375 per annum

(iv) Vocational training 1,450 per annum

(v) Employment of an assistant (full time) or where the principal (or in a partnership all principals) receive an addition as the practice is in a designated area 4,410 per annum

3. Payments for out of hours responsibilities:

(i) Supplementary practice allowance

216W

Rates at 1 November 1984 £

(a) Full rate 1,345 per annum

(b) First 100 patients 265 per annum

(c) Each patient above 100 to 999 1.20 per annum

(ii) A Supplementary Capitation fee for each patient in excess of 1,000 on the practitioner's list (or in excess of 1,000 per practitioner on the combined list of practitioners, practising in partnership) 1.31 per annum

(iii) A fee for a night visit 14.90 per annum

4. A fee for an item of service carried out for reasons of public policy:

(i) Vaccination and immunisation

Fee A 2.20 per annum

Fee B 3.20 per annum

(ii) Cervical cytology test 6.40 per annum

5. Fees for provision of contraceptive services:

(i) Ordinary 8.55 per annum

(ii) Intrauterine device 28.70 per annum

6. Fees for the provision of maternity medical services: On obstetric list Not on obstetric list

(i) Complete maternity services 100.00 58.35

(ii) Ante-natal care:

(a) Woman booking up to the 16th week of pregnancy 54.00 31.50

(b) Woman booking from the 17th week to the 30th week of pregnancy 40.50 23.65

(c) Woman booking from the 31st week of pregnancy 27.00 15.75

(iii) Miscarriage 33.35 20.85

(iv) Care during confinement 23.00 13.35

(v) Complete post-natal care 23.00 16.35

(vi) Partial postnatal care

(a) Each attendance subject to a 3.05 2.15

maximum of 15.25 10.75

(b) Full postnatal examination 7.75 5.60

(vii) Second practitioner called in to give anaesthetic 21.30 21.30

7. A fee for the treatment of a temporary resident who:

(i) Expects to remain in the district for not more than 15 days 4.90

(ii) Expects to remain in the district for more than 15 days 7.35

8. A fee for treatment given by a practitioner in an emergency not in his list and not eligible to be treated as a temporary resident:

(i) Emergency consultation

(a) Involving a night visit 14.90

(b) Other 12.75

(ii) Minor surgical operation requiring anaesthetic 12.75

(iii) Treatment of fracture 12.75

(iv) Reduction of dislocation 12.75

(v) Administration of general anaesthetic 21.30

9. A payment in cases in which a practitioner is required to provide the services of a second practitioner for the purposes of administering general anaesthetic except in connection with maternity medical services 21.30

217W

Rates at 1 November 1984 £

10.

(i) Fee for the arrest of dental haemorrhage or for the provision of after care 12 . 75

(ii) Fee for the removal of plugs and/or stitches only 8.70

11. A fee for immediately necessary treatment given by a practitioner under paragraphs 6(3) or 4(4) of his terms of service 4.90 or 7.35

12. Postgraduate training allowance 605

13. Payments in respect of the Trainee Practitioner Scheme

(i) Training grant 3,160 per annum

(ii) Allowance for additional motor vehicle:

(a) For one year's full-time training 2,241

(b) For two years' part-time training (for each year) 1,398

(iii) Trainees salary and board and lodging — approx. maximum payment (dependent on last hospital post) 10,270 to 16,917

(iv) London Weighting

(a) London Zone 807 per annum

(b) The Fringe Area 149 per annum

14. Payments under the Doctors' Retainer Scheme 21.35 per session

15. Initial Practice Allowance Maximum allowance

(i) Type A First year 11,310

Second year 7,540

Third year 3,770

Fourth year 1,885

(ii) Type B First year 18,850

Second year 7,540

(iii) Type C First year 9,900

Second year 7,425

Third year 4,950

Fourth year 2,475

(iv) Type D Guaranteed net income:

(a) First doctor 28,690

(b) Two partners joint net income 50,760

16. Payments in respect of the supply of drugs and appliances Various

17. Inducement payments Various

18. Additional payments during sickness ^*213.50 per week

19. Additional payments during confinements

20.

(a) Prolonged study leave allowance 31.40 per week

(b) Educational allowance locum allowance Up to a maximum of 213.50 per week

21. Payments under the Rent and Rates Scheme Various

22. Payments under the Ancillary Staff Scheme Various

218W

Rates at 1 November 1984 £

23. Related Ancillary Staff Allowance 1,760 per annum

24. Improvement Grant Various

§ Mr. Hickmet
asked the Secretary of State for Social Services how many general practitioners operating within the National Health Service are over the age of 65 years.

§ Mr. Kenneth Clarke
The number of unrestricted principals in England practising in the National Health Service aged 65 and over at 1 October 1984 was 1,189.

§ Mr. Hickmet
asked the Secretary of State for Social Services how many and what representations he has made to the General Medical Services Committee and elsewhere about a fixed retirement age for general practitioners; what was the response; when he will next make representations; and if he will make a statement.

§ Mr. Kenneth Clarke
We have made no representations and no decision yet about a fixed retirement age.

	Rates at 1 November 1984 £
1. Basic Practice Allowance:
(a) Full rate	6,760	per annum
(b) First 100 patients	1,360	per annum
(c) Each patient above 100 to 999	6 . 00 per annum
(d) Leave payment	1,352	per annum
2. Additions to Basic Practice Allowance in respect of:
(i) Pratice in a designated area
Type 1	2,095	per annum
Type 2	3,195	per annum
(ii) Practice as a member of a group	1,175	per annum
(iii) Seniority
First payment	1,620	per annum
Second payment	2,760	per annum
Third payment	4,375	per annum
(iv) Vocational training	1,450	per annum
(v) Employment of an assistant (full time) or where the principal (or in a partnership all principals) receive an addition as the practice is in a designated area	4,410	per annum
3. Payments for out of hours responsibilities:
(i) Supplementary practice allowance

	Rates at 1 November 1984 £
(a) Full rate	1,345	per annum
(b) First 100 patients	265	per annum
(c) Each patient above 100 to 999	1.20 per annum
(ii) A Supplementary Capitation fee for each patient in excess of 1,000 on the practitioner's list (or in excess of 1,000 per practitioner on the combined list of practitioners, practising in partnership)	1.31 per annum
(iii) A fee for a night visit	14.90 per annum
4. A fee for an item of service carried out for reasons of public policy:
(i) Vaccination and immunisation
Fee A	2.20 per annum
Fee B	3.20 per annum
(ii) Cervical cytology test	6.40 per annum
5. Fees for provision of contraceptive services:
(i) Ordinary	8.55 per annum
(ii) Intrauterine device	28.70 per annum
6. Fees for the provision of maternity medical services:	On obstetric list	Not on obstetric list
(i) Complete maternity services	100.00	58.35
(ii) Ante-natal care:
(a) Woman booking up to the 16th week of pregnancy	54.00	31.50
(b) Woman booking from the 17th week to the 30th week of pregnancy	40.50	23.65
(c) Woman booking from the 31st week of pregnancy	27.00	15.75
(iii) Miscarriage	33.35	20.85
(iv) Care during confinement	23.00	13.35
(v) Complete post-natal care	23.00	16.35
(vi) Partial postnatal care
(a) Each attendance subject to a	3.05	2.15
maximum of	15.25	10.75
(b) Full postnatal examination	7.75	5.60
(vii) Second practitioner called in to give anaesthetic	21.30	21.30
7. A fee for the treatment of a temporary resident who:
(i) Expects to remain in the district for not more than 15 days	4.90
(ii) Expects to remain in the district for more than 15 days	7.35
8. A fee for treatment given by a practitioner in an emergency not in his list and not eligible to be treated as a temporary resident:
(i) Emergency consultation
(a) Involving a night visit	14.90
(b) Other	12.75
(ii) Minor surgical operation requiring anaesthetic	12.75
(iii) Treatment of fracture	12.75
(iv) Reduction of dislocation	12.75
(v) Administration of general anaesthetic	21.30
9. A payment in cases in which a practitioner is required to provide the services of a second practitioner for the purposes of administering general anaesthetic except in connection with maternity medical services	21.30

	Rates at 1 November 1984 £
10.
(i) Fee for the arrest of dental haemorrhage or for the provision of after care	12 . 75
(ii) Fee for the removal of plugs and/or stitches only	8.70
11. A fee for immediately necessary treatment given by a practitioner under paragraphs 6(3) or 4(4) of his terms of service	4.90 or 7.35
12. Postgraduate training allowance	605
13. Payments in respect of the Trainee Practitioner Scheme
(i) Training grant	3,160	per annum
(ii) Allowance for additional motor vehicle:
(a) For one year's full-time training	2,241
(b) For two years' part-time training (for each year)	1,398
(iii) Trainees salary and board and lodging — approx. maximum payment (dependent on last hospital post)	10,270 to 16,917
(iv) London Weighting
(a) London Zone	807	per annum
(b) The Fringe Area	149	per annum
14. Payments under the Doctors' Retainer Scheme	21.35 per session
15. Initial Practice Allowance	Maximum allowance
(i) Type A First year	11,310
Second year	7,540
Third year	3,770
Fourth year	1,885
(ii) Type B First year	18,850
Second year	7,540
(iii) Type C First year	9,900
Second year	7,425
Third year	4,950
Fourth year	2,475
(iv) Type D Guaranteed net income:
(a) First doctor	28,690
(b) Two partners joint net income	50,760
16. Payments in respect of the supply of drugs and appliances	Various
17. Inducement payments	Various
18. Additional payments during sickness	^*213.50 per week
19. Additional payments during confinements
20.
(a) Prolonged study leave allowance	31.40 per week
(b) Educational allowance locum allowance	Up to a maximum of 213.50 per week
21. Payments under the Rent and Rates Scheme	Various
22. Payments under the Ancillary Staff Scheme	Various

	Rates at 1 November 1984 £
23. Related Ancillary Staff Allowance	1,760	per annum
24. Improvement Grant	Various