§ The Countess of Marasked Her Majesty's Government:
How they propose to ensure the viability of doctors' practices in rural areas under the proposed new contract and the White Paper Working for Patients, where the size of the population is static and they are unable to attain the same targets as those who have practices in urban areas; and
Whether they will give particular consideration to women doctors who, because they work part-time, may not have a patient list which meets the minimum required under the new contract.
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§ Lord HenleyOn 4th May, the Secretary of State for Health reached agreement with the BMA's General Medical Services Committee on all the major outstanding issues in the proposed new contract for general practitioners. As a result the Secretary of State has modified his proposals in several ways which will be welcomed by GPs visiting to work part-time.
First, it has been agreed that the present rural practice payments scheme will be retained pending its revision by the Central Advisory Committee on Rural Practice Payments. GPs serving rural areas will also welcome the inclusion of home visits in the required hours of availability per week—although the number of hours' availability will increase from 20 to 26 to reflect this—and the change to enable ad hoc minor surgical operations to count towards the monthly sessional payment.
The Government wish to see a scheme which will ensure a continued high standard of service to patients in rural areas, and which will appropriately compensate those doctors who necessarily have smaller lists.
Secondly it was also agreed that the minimum list size for receipt of basic practice allowance will in future be 400, rather than 500 as previously proposed, and entitlement will be based on partnership average list sizes rather than personal lists. This will benefit both the rural doctors with small lists and doctors working part-time. The Government are committed to encouraging and facilitating flexible working arrrangements, particularly for women with family or other
(a) DISCHARGES (1) FROM MENTAL ILLNESS HOSPITALS AND UNITS, WITH A DIAGNOSIS OF SCHIZOPHRENIA (2), ENGLAND 1984–86 Duration of stay Year All discharges Diagnosis schizophrenia 1984, with All diagnosis % All discharges, Diagnosis schizophrenia 1985, with All diagnosis % All discharges, Diagnosis schizophrenia 1986, with All diagnosis % All durations 25,934 183,393 14.15 26,225 188,225 13.90 26,077 188,423 13.84 Less than 1 month 13,093 112,759 11.61 13,617 116,919 11.65 13,307 115,868 11.48 Less than 3 months 20,599 161,333 12.77 21,101 167,242 12.62 20,665 166,113 12.44 Less than 6 months 22,708 172,552 13.16 23,260 178,650 13.02 22,872 177,758 12.87 (1)All discharges, excluding deaths (2) 9th Revision, International Classification of Diseases, 295.0–295.9
(b) DISCHARGES (1) FROM PSYCHIATRIC HOSPITALS. WITH A DIAGNOSIS OF SCHIZOPHRENIA (2) SCOTLAND 1984–86 Duration of stay Year All discharges Diagnosis schizophrenia 1984, with All diagnosis % All discharges, Diagnosis schizophrenia 1985, with All diagnosis % All discharges, Diagnosis schizophrenia 1986, with All diagnosis % All durations 3,268 26,734 12.22 3,409 27,853 12.24 3,342 27,761 12.04 Less than 1 month 2,222 21,480 10.34 2,264 22,003 10.29 2,321 22,338 10.39 Less than 3 months 2,885 25,114 11.49 2,961 25,810 11.47 2,983 26,007 11.47 Less than 6 months 2,972 25,507 11.65 3,051 26,208 11.64 3,060 26,419 11.58 (1) All discharges, excluding deaths (2) 9th Revision, International Classification of Diseases, 295.0–295.9 390WA
(c) DISCHARGES (1) FROM MENTAL ILLNESS HOSPITALS AND UNITS, WITH A DIAGNOSIS OF SCHIZOPHRENIA (2), NORTHERN IRELAND. 1984–86 Duration of stay Year All discharges Diagnosis schizophrenia 1984, with All diagnosis % All discharges, Diagnosis schizophrenia 1985, with All diagnosis % All discharges, Diagnosis schizophrenia 1986, with All diagnosis % All durations 1,064 8,211 12.96 1,088 8,257 13.18 991 7,334 13.51 Less than 1 month 484 4,982 9.71 488 4,756 10.26 456 4,228 10.79 Less than 3 months 857 7,432 11.53 902 7,488 12.05 827 6,571 12.59 Less than 6 months 976 7,918 12.33 1,003 7,927 12.65 907 7,013 12.93 (1) All discharges, excluding deaths (2) 9th Revision, International Classification of Diseases, 295.0–295.9 commitments. In formalising the arrangements for flexible working, the Government will take fully into account the likely list sizes of such doctors. Women doctors will welcome the easing of qualification for the locum allowance during confinement. The increases in the assistant's allowances will help those GPs who do not want the responsibility of a partner in general practice.