§ Ms. HarmanTo ask the Secretary of State for Health (1) where a district health authority, under the White Paper on the National Health Service, has contracted with an out-of-district hospital for a particular service, whether patients will have the choice of getting treatment for that service within the district;
(2) where, under the White Paper on the National Health Service, a district health authority has contracted with a hosiptal outside its district to provide a particular service, whether patients from that district health authority will have to travel to the out-of-district hospital for that service.
§ Mr. Kenneth Clarke[holding answer 9 February 1989]: Hospital patients are not necessarily best or most conveniently treated within the administrative boundaries of their district health authorities. The White Paper's proposals will make it possible for NHS funds to cross those boundaries when patients and GPs choose treatment elsewhere—for example, because waiting times are shorter. When placing contracts each DHA will need to take account of the existing referral patterns of local GPs, and will be free to place contracts with more than one hospital. They will need to discuss with GPs the possibility of changing existing patterns of referral if they believe that better value for money can be obtained by doing so. DHAs will also need to allow for referrals by GPs to hospitals with which no contracts have been placed, keeping some funds in reserve for this purpose.
§ Ms. HarmanTo ask the Secretary of State for Health how health authorities are to be reimbursed for accident and emergency admissions from patients outside their own district of residence under the proposals in the National Health Service White Paper.
§ Mr. Kenneth Clarke[holding answer 9 February 1989]: My proposals on meeting the costs of accident and emergency admissions will be spelt out in a working paper on funding and contracts to be issued shortly.