§ Mr. DonohoeTo ask the Secretary of State for Scotland how much his Department has spent in each of the last five financial years promoting the development of GP fundholding; and what initiatives have been undertaken to do this. [7165]
§ Lord James Douglas-HamiltonExpenditure incurred by the Department in developing fundholding is largely indirect costs, and cannot be separately identified. A specific initiative has however been undertaken to develop models of total purchasing in which a budget is devolved to groups of practices to purchase all community and hospital health care for their patients. Six total purchasing pilots were established in 1995–96 in Scotland and a further site was added in 1996–97. The total cost of the initiative was £1.4 million in 1995–96 and £1.5 million in 1996–97.
§ Mr. DonohoeTo ask the Secretary of State for Scotland on what basis the management allowances payable to GP fundholders are calculated; and what are the maximum and minimum amounts a fundholding practice can receive. [7166]
777W
§ Lord James Douglas-HamiltonWithin the limits set down, the management allowance payable is for health boards to determine on the basis of information provided by GP fundholders in their practice plans. Before agreeing the amount for each practice, the health board must be satisfied that it represents value for money. From 1 April 1996, the maximum allowances available are calculated as follows:
£ Standard fundholding practices Fixed standard fundholding allowance (per fund) 28,008 List size allowance per patient: for the first 0–6,999 1.93 then 7,000–10,999 1.65 then 11,000–14,999 1.56 then 15,000–20,999 1.20 then 20,000+ 1.05 Site allowance (for each major branch surgery) 668 Standard fundholding group allowance (for each practice in excess of one in a single fund) 1,439
Table 1: GP fundholder management allowance £000 Health Board 1990–91 1991–92 1992–93 1993–94 1994–95 11995–96 Argyll and Clyde 5 17 134 170 211 830 Aryshire and Arran — — 77 132 133 194 Borders — — 26 55 71 169 Dumfries and Galloway — — — 33 92 218 Fife — — 36 85 125 322 Forth Valley — 32 86 127 165 306 Grampian — 85 539 1,006 1,310 2,027 Greater Glasgow — 35 90 275 552 1,214 Highland — — 34 101 105 439 Lanarkshire — — 178 418 535 1,251 Lothian 16 33 168 429 697 1,098 Orkney — — — — — — Shetland — — — — — — Tayside 4 50 186 283 337 688 Western Isle — — — — — — Scotland 25 252 1,554 3,114 4,333 8,756 1 Provisional. 778W
Table 2: GP fundholding practices Health board 1 April 1991 1 April 1992 1 April 1993 1 April 1994 1 April 1995 1 April 1996 Argyll and Clyde 1 5 5 5 18 33 Ayrshire and Arran — 2 6 5 7 8 Borders — — 3 3 7 10 Dumfries and Galloway — — 1 3 9 11 Fife — 1 3 5 16 17 Forth Valley — 2 3 5 12 17 Grampian 6 26 38 39 42 47 Greater Glasgow — 2 14 30 60 101 Highland — 1 4 7 18 21 Lanarkshire — 2 11 16 17 32 Lothian 2 3 14 25 36 54 Orkney — — — — — — Shetland — — — — — — Tayside 4 8 10 12 20 31 Western Isles — — — — 2 3 Scotland 13 52 112 155 264 385
£ Primary care purchasing practices Fixed primary care purchasing allowance (per fund) 14.135 Site allowance (for each major branch surgery) 650 Standard primary care purchasing group allowance (for each practice in excess of one in a single fund) 1,250 There is no minimum management allowance. The allowances listed are the maximum which fundholding practices are permitted to spend for fund management purposes.
§ Mr. DonohoeTo ask the Secretary of State for Scotland what was(a) for each health board area in Scotland and (b) for the whole of Scotland (i) the amount spent on management allowances for GP fundholders and (ii) the number of GP fundholding practices in each year since 1990–91 [7167]
§ Lord James Douglas-HamiltonExpenditure on management allowances for general practitioner fundholding practices in the period 1990–91 to 1995–96 is set out in table 1. The number of general practitioner fundholding practices from 1990–91 is set out in table 2.