§ Mr. FoulkesTo ask the Secretary of State for Scotland how many general practitioner practices had become fundholders at the end of 1994 in each health board area in Scotland; what percentage of total practices this represents; and what plans he has in respect of practices which have decided not to opt for fundholding status.
§ Lord James Douglas-Hamilton[holding answer 10 January 1995]: The information requested is set out in the table.
Health board Operational fundholders Percentage of total practices Argyll and Clyde 5 4.6 Ayrshire and Arran 4 6.0 Borders 2 8.3 Dumfries and Galloway 1 2.7 Fife 4 6.5 Forth Valley 4 7.1 Grampian 31 33.3 Greater Glasgow 11 4.8 Highland 3 3.9 Lanarkshire 15 16.3 Lothian 18 12.7 Orkney 0 0 Shetland 0 0 Tayside 9 10.6 Western Isles 0 0 Total 107 9.6 The GP fundholding scheme is a voluntary scheme which is currently open to practices with 6,000 or more patients or which can group together to achieve this figure.
Under proposals announced on 25 November by my noble Friend the Minister of State it is intended to expand and develop the GP fundholding scheme to allow GP practices a range of options, to participate directly in purchasing health services for the benefit of their patients. This will be subject to parliamentary approval for amendments to the regulations. It will include an expanded standard fundholding scheme from 1 April 1996, including a reduction in the minimum list size requirement to 4,000 patients, and a new primary care purchasing initiative which, subject to successful piloting, it is hoped can be made available to all GP practices in Scotland irrespective of list size. Interest is also being canvassed, amongst experienced GP fundholding practices in Scotland, to participate in up to six pilot projects to evaluate the possible benefits of fundholding 170W practices having the option of purchasing all hospital and community health services on behalf of their patients.
These new arrangements are intended to facilitate the process whereby GP practices enter the fund holding scheme in a more flexible way. The resultant participation by increased numbers of practices will assist health boards to ensure that their purchasing of health services for patients is led by primary care priorities. Health boards also have the responsibility to make effective arrangements for consultation with all their GP practices about their purchasing plans, and such arrangements will include also inputs from GP practices which are not directly involved in the fundholding scheme.