General Practitioner Contract (Hansard, 8 March 1990)

§ Miss Emma Nicholson
To ask the Secretary of State for Health (1) if he will allow general practitioners to subtract contra-indications from target figures for cervical cytology and immunisation programmes under the new contract arrangements;
(2) if he will allow general practitioners to subtract informed dissenters from target figures for cervical cytology and immunisation programmes under the new contract arrangements;
(3) what consideration he has given to the effect on general practitioner-patient relationships of not allowing general practitioners to subtract informed dissenters and contra-indications from target figures for cervical cytology and immunisation programmes under the new contract arrangements;
(4) what information his Department has on the potential numbers of (a) informed dissenters and (b) contra-indications who will not take part in cervical cytology and immunisation programmes.

§ Mrs. Virginia Bottomley
The prevention of childhood diseases and cancer of the cervix is a high priority for the Government. We believe that the new target payment system will encourage GPs to improve levels of immunisation and screening and thereby reduce the incidence of these distressing diseases. The coverage levels at which target payments will be made have been set below 100 per cent. to allow for patients who, for any reason, do not wish to take advantage of these services. No data are available about the numbers of such patients but the experience of practices with high levels of cover suggests that the numbers are not great and that the higher level targets are achievable. The number of children who show contra-indications is small—less than 2 per cent. overall. The Government are satisfied that the new arrangements will have no deleterious effect on the relationship between patients and general practitioners.

§ Miss Emma Nicholson
To ask the Secretary of State for Health if he will alter the general practitioner contract to allow a peer group of medical practitioners and not family practitioner committees to scrutinise cervical smear exclusion data.

§ Mrs. Virginia Bottomley
We see no need for such arrangements. Family practitioner committees have a clearly defined management function in handling payment claims from doctors who are in contract with them.

§ Miss Emma Nicholson
To ask the Secretary of State for Health if he will anonymise patient data from women who have undergone hysterectomies for the purpose of ensuring confidentiality under the new general practitioner contract target arrangements.
823W

§ Mrs. Virginia Bottomley
The final details of the information that GPs will need to supply to family practitioner committees (FPCs) when claiming target payments have yet to be settled. No more information than is absolutely necessary for checking and audit purposes will be required by FPCs to approve the appropriate payments. All clinical information is treated on a confidential basis.

§ Miss Emma Nicholson
To ask the Secretary of State for Health if he will exclude from general practitioner target payment figures nuns, virgins and women who do not wish to undergo a cervical smear.

§ Mrs. Virginia Bottomley
No. To exclude women who do not wish to be screened would not be consistent with the objective of the target payments scheme, which is to encourage GPs to point out the benefits to their patients of screening for cancer of the cervix. We believe it is a sensible precaution to include within the target scheme all women in the vunerable age group who have not had hysterectomies.