§ Mr Dobsonasked the Secretary of State for Social Services (1) if he will list the differences between the draft handbook on the management of private practice issued in July 1985 and the final handbook published in March 1986;
(2) if he will list the differences between the handbook on the management of private practice issued in March 1986 and his Department's guidance to health authorities before the release of the handbook in its draft form in July 1985.
§ Mr. HayhoeThe differences between the draft and final versions of the handbook reflect the outcome of wide consultation on the draft. The principal changes made were as follows. In the passage on access to National Health Service facilities, it has been made clear that private in-patients and the private patients of general 273W practitioners are legally entitled to become NHS patients, whilst emphasising that those who do change status must gain no advantage over other NHS patients by so doing. The passage on rental agreements has been amended to indicate that agreements between a health authority and a consultant for the use of accommodation in NHS hospitals to see private patients covered by sections 65 and 66 of the NHS Act 1977 should not be made. The rules governing release of health records have been described with greater precision. There were many other detailed amendments to the presentation rather than to the substance.
Previously, guidance to health authorities was spread over a number of separate circulars issued in the last six years, and was not comprehensive. One of the main purposes of the handbook was to draw all the relevant material together in one place to help health authorities to manage private practice more effectively. Most of the earlier guidance remains unchanged in the handbook, but there are many differences apart from those listed above. For example, a description of the legislative framework is included. The designation of private patient officers is made a requirement. The respective responsibilities of health authorities and hospital consultants are set out. The guidance on identification of private patients and on obtaining undertakings to pay charges makes plain that, while a system to be universally used is not being
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Districts Percentage of Service put out to Tender Estimated Annual Savings Catering Domestic Laundry (£000's) Northern Regional Health Authority Hartlepool 12 30 nil — North Tees nil 14 nil 14 South Tees 100 12 nil 76 East Cumbria nil 32 nil — South Cumbria nil 100 100 257 West Cumbria 3 3 nil 1 Darlington 100 nil 100 300 Durham nil nil nil — North West Durham nil 100 100 141 South West Durham 2 2 nil — Newcastle 47 79 22 1,025 North Tyneside nil 60 100 176 South Tyneside 38 80 nil 31 Sunderland 3 5 nil 24 Northumberland 11 15 29 108 Gateshead 51 43 nil 375 Yorkshire Regional Health Authority Hull 13 25 nil 150 East Yorkshire nil 26 56 298 Grimsby 76 52 nil 223 Scunthorpe 61 71 nil 275 Northallerton 100 nil 100 16 York nil 49 nil 278 Scarborough 28 24 100 48 Harrogate 21 26 nil 38 Bradford nil 11 nil 17 Airedale 32 21 nil 28 Calderdale 100 100 100 530 Huddersfield nil 46 44 323 Dewsbury nil 47 100 397 Leeds Eastern nil nil nil — Leeds Western 24 27 100 272 Wakefield 11 nil 100 — Pontefract nil 100 100 485 Trent Regional Health Authority North Derbyshire 82 68 nil 197 South Derbyshire nil 14 nil 85 Leicestershire nil 50 nil 783 North Lincolnshire 1 33 100 186 prescribed, a proper system capable of identifying private patients and getting an undertaking from them must be in place in every health authority. Exemptions from obtaining undertaking to pay charges are removed. Consultants are no longer allowed to act as authorities' agents for the collection of hospital charges. Private patients are required to meet the full cost of non-emergency ambulance transport.
The changes overall make for greater clarity and precision in the guidance issued to health authorities in the handbook published last month.