§ Mr. Michael MorrisTo ask the Secretary of State for Health whether any assessment has been undertaken on the benefits to out-patients' departments of requiring general practitioners to undertake all minor surgery operations, rather than a selection of such operations.
§ Mrs. Virginia BottomleyNo, but it is a reasonable expectation that the more minor surgery that GPs can carry out in their own surgeries, the fewer visits patients will have to make to the out-patients' department (OPD) and the more time OPD doctors will have to respond to other patient care needs. There is a practical difficulty in assessing with any accuracy the effect of the new arrangements on out-patient departments. Once on the minor surgery list, a GP is not required to undertake every procedure in which he or she is competent every time a patient presents with the relevant condition. It has to be a matter of clinical judgment on the part of the GP as to what action to take in the light of the particular circumstances. Arrangements for monitoring the GPs'
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§ Mrs. Virginia BottomleyHealth authorities will he expected to assess outcomes in monitoring the contracts they make with providers of health services. The new purchasing role will give district health authorities strong incentives to move from specifying input to developing measures of health outcome. The Department is developing a methodology for outcome assessment, and guidance for health authorities to equip them to monitor outcome effectively.