§ Mr. Maxwell-HyslopTo ask the Secretary of State for Health whether, in the 1990 contract(a) "The Public Service" includes schools which have opted out from local education authority control, local education authority schools and further education colleges, (b) in paragraph 13(a) the £400,000 fund is annually refreshed by that amount and for post-graduate teaching only, (c) the definition of sparsely populated areas in paragraph 13(b) is altered; and (d) to qualify under paragraph 26 a general practitioner must be qualified to perform all operations on the list of surgical procedures.
§ Mr. Mellor[holding answer 19 October 1989]: The National Health Service (General Medical and Pharmaceutical Services) Amendment (No. 2) Regulations 1989, laid on 16 October, set out the criteria by which FPCs should determine applications from GPs to work over four instead of five days a week. It will therefore be for the FPC to decide whether the provision of health care services to local education authority schools and further education colleges, whether opted out or not, may justify a GP providing general medical services over four rather than five days. The fund of up to £400,000 a year is recurrent, and will mainly be directed at undergraduate teaching. As regards "sparsely populated areas", no change is being made to the inducement practice scheme. To qualify for inclusion on the minor surgery list, a doctor must demonstrate competence to undertake all the procedures listed in schedule 1B of the amending regulations.
§ Mr. Maxwell-HyslopTo ask the Secretary of State for Health whether, in the 1990 contract(a) the paragraph 51 general practitioner age limits apply to locums and assistant doctors, (b) time spent by general practitioners on representational work on official bodies can be subtracted from the 26 hours, referred to in paragraph A2, (c) the substantial extra resources referred to in paragraph 58 means resources new to the National Health Service, or resources reallocated within it and (d) proof of posting an offer, paragraph A7 will constitute offering the required services to a post-75 patient; and who bears the cost of paragraph A13 reports.
§ Mr. Mellor[holding answer 19 October 1989]: Locums and assistant doctors who are not included in an FPC medical list are not affected by the introduction of a compulsory retirement age. Under the revised terms of service, a doctor will be required to be available to his patients for at least 26 hours over five days a week at times convenient to patients. Provision is made for an FPC to agree that a GP may fulfil this requirement over four instead of five days, provided the GP satisfies the criteria set out in the National Health Service (General Medical and Pharmaceutical Services) Amendment (No. 2) Regulations 1989.
Because a number of fees and allowances will be abolished, it will be necessary to redistribute a considerable proportion of the funds currently expended on general medical services to meet the costs of new payments. The reference to "substantial extra resources" in paragraph 2.6 of the White Paper "Promoting Better Health" and quoted in paragraph 58 of "The 1990 Contracts" referred to extra investments additional to current expenditure. Where a GP makes an offer in writing 633W to a patient aged 75 or over under paragraph 13D of the revised terms of service, proof of posting the written offer will be accepted as discharging the responsibility to make such an offer. Should the patient accept the offer, the GP will be required to carry out the check-up as laid down in those terms of service.
The production of annual reports by practices will not be a significant expense and, as with other expenses related to the provision of general medical services, will be reimbursed to the profession indirectly through fees and allowances.