§ Mrs. DunwoodyTo ask the Secretary of State for Health what consultations will be held with(a) the staff and (b) the local authority representing the catchment area of any general district hospitals that apply to opt-out.
§ Mr. MellorSelf-governing trusts will not opt out but will remain fully within the NHS. When a unit decides to submit an application, the RHA will seek the views of those with an interest, particularly the health authority concerned, staff at the hospital, GPs, CHCs and the local community. The Secretary of State will consider any responses alongside the application.
§ Mr. David PorterTo ask the Secretary of State for Health what representations he has had from general practitioners and others on the effects of the proposals in "Working for Patients" on rural practices; and if he will make a statement.
§ Mr. Mellor[holding answer 19 June 19891: We have received a number of representations from doctors about the possible effects on rural practice of our proposal to increase to 60 per cent. the proportion of a GP's income represented by capitation payments.
A number of features of the new contract will be of benefit to GPs serving rural areas, including the new payments linked to the provision of specific services such as health promotion clinics, minor surgery and child health surveillance and the higher level of night visit fee. The new weighting of basic practice allowance will also benefit GPs with small lists including GPs in rural areas. In particular, the inclusion of home visits in the 26 hours a week availability, and the scope for GPs to fulfil this requirement over four rather than five days where the fifth day is spent on health-related activities in the public sector, will be welcomed by such GPs.
In recognition of the strength of feeling among rural GPs against our earlier proposal to introduce a new rural supplement, we agreed with the general medical services committee's negotiators on 4 May that the rural practice payments scheme will continue pending its revision by the central advisory committee on rural practice payments.
§ Sir David PriceTo ask the Secretary of State for Health what change in administrative arrangements he intends to introduce for those specialised regional units in teaching hospitals where a close working relationship between the basic scientific research and developing clinical practice is common practice.
§ Mr. MellorThe Government are still developing the details necessary for the implementation of "Working for Patients", but they recognise the value of the links between basic scientific research and developing clinical practice, and are taking these into account as their plans develop.
§ Mr. Harry GreenwayTo ask the Secretary of State for Health if he will detail those points where a substantial number of general practitioners are understood to support the National Health Service White Paper; and if he will make a statement.
§ Mr. Kenneth ClarkeA substantial number of general practitioners support our proposals for: 103W
retaining the principles on which the NHS was based; better management in the NHS and the greater involvement of doctors in it;clinically led medical audit;extending resource management and better information systems so that the costs and results of decisions can be taken fully into account and so that the health service, for the first time, knows what it is doing, why, at what cost and to what standards;the need for a comprehensive health service;the vital role of a high standard of medical education and of an effective research programme;the need to build on the excellent track record of the NHS to meet the changing demands of the coming decade; the principle of money following patients; andmany general practitioners have expressed interest in practice budgets.We are continuing discussions with representatives of the medical profession on the implementation of these and our other proposals.