§ 42. Ms. HarmanTo ask the Secretary of State for Health how many general practitioner practices currently employ practice managers; and what his estimate is of the number of general practitioner practices which would employ practice managers to administer budgets as proposed in the National Health Service White Paper.
§ Mr. Kenneth ClarkeWe do not collect centrally figures relating to the employment of practice managers by general practitioners. However, a survey in 1986 indicated that in Great Britain there were about 3,000 practice managers working approximately 30 hours a week. Over a quarter of all practices employed practice managers: this ranged from 10 per cent. of single-handed practices to almost 60 per cent. of practices with five or more doctors. We would expect these figures to have increased in the intervening period.
It will be for general practitioners themselves to decide on the level of support required to administer their practice budgets and whom to employ.
§ Ms. HarmanTo ask the Secretary of State for Health what is his estimate of the future changes in general practitioners' list sizes if the proportion of income attributable to capitation fees is increased from 46 Viper cent. to 60 per cent., as proposed in the White Paper, "Working for Patients".
§ Mr. Kenneth ClarkeWe expect GPs' list sizes to settle at levels which enable GPs to provide good quality care to their patients. Patients will be able to judge that care and the service they receive for themselves and will be free to transfer between practices as they choose.
§ Ms. HarmanTo ask the Secretary of State for Health whether there will be a maximum number of patients a general practitioner can have on his/her list under the National Health Service White Paper.
§ Mr. Kenneth ClarkeAt present, the maximum number of patients an individual general practitioner can have on his/her list is 3,500 or, if he/she is in partnership, 4,500 subject to an average of 3,500 for each of the partners in the practice.
The current arrangements are being considered within the context of the primary care White Paper "Promoting Better Health".
§ Ms. HarmanTo ask the Secretary of State for Health whether patients of a budget-holding general practitioner practice as proposed under the White Paper, "Working for Health", will be able to top up the budget(a) individually or (b) collectively.
§ Mr. Kenneth ClarkeThe White Paper, "Working for Patients", makes clear that general practitioner practices participating in the practice budget scheme will be allocated NHS resources for the treatment of patients. I 801W have no plans to allow patients individually or collectively to make a personal contribution to the NHS practice budget.