§ Mr. BattleTo ask the Secretary of State for Health (1) what assessment he has made of the attainability of the assumptions of 80 per cent. screening of eligible women and 90 per cent. of childhood immunisation set out in "General Practice in the National Health Service—A New Contract" and what account was paid to patient resistance in setting these targets;
(2) what estimate he has made of the potential disincentive effect on general practitioners undertaking screening and childhood immunisation of the levels at which the target take-up rates have been set.
§ Mr. MellorGPs will be required under their terms of service to provide health promotion and illness prevention services. These services will include advising patients on the wisdom of attending for screening and of immunising children. It is Departmental policy to achieve 80 per cent. coverage of women aged 20–65 for cervical cancer346W screening, and 90 per cent. coverage for immunisation of children under five. These target coverage levels provide a sufficient margin to allow for cases where screening or immunisation would not be appropriate.
We believe that these levels are attainable. In 1987–88 in England childhood immunisation coverage levels were 87 per cent. for polio (with diphtheria and tetanus), 76 per cent. for measles and 71 per cent. for whooping cough with uptake rates for the last two accelerating. Recent initiatives such as the introduction of the MMR vaccine will lead to further improvements. By replacing item of service payments for these services with payments related to achievement of the target coverage levels we will reward the good GPs who already reach those levels and introduce a powerful incentive for those who do not.