§ Mr. MorganTo ask the Secretary of State for Wales what assessment he has made of how the proposed changes in the extra-contractual referral system reducing the prior notification and approval system will affect the access to treatment of patients of(a) fundholding and (b) non-fundholding general practitioners; and if he will make a statement. [39691]
§ Mr. HagueProposed changes in the extra-contractual referral system will not reduce the access to treatment of patients of either fundholding or non-fundholding general practitioners.
§ Mr. MorganTo ask the Secretary of State for Wales if he will list those making representations concerning the contents of the departmental letters of 12 and 20 June concerning extra-contractual referral administration. [39715]
§ Mr. HagueIn response to departmental letters of 12 and 20 June about extra-contractual referrals, commetns were received from the following:
- Clwydian Community Care NHS Trust
- Derwen NHS Trust
- Rhondda NHS Trust
- Carmarthen & District NHS Trust
- Nevill Hall & District NHS Trust
- Cardiff Community Healthcare NHS Trust
§ Mr. MorganTo ask the Secretary of State for Wales (1) what estimate he has made of the(a) number and (b) cost of treatments no longer requiring to be notified to purchasers in advance of treatment by virtue of the 2 July letter of guidance to health authorities, trusts and fundholders (i) between 1 August 1996 and 31 March 1997 and (b) in a typical year; and what is the estimated net annual administrative cost saving; [39739]
(2) what assessment he has made of the level of extra-contractual referral activity in Wales in the financial years 1994–95 and 1995–96; what proportion of the total cost of extra-contractual referral was for (a) tertiary referral and (b) emergency reasons; what the total cost 388W was of administering the extra-contractual referral system for the latest available financial year; and if he will make a statement. [39710]
§ Mr. MorganTo ask the Secretary of State for Wales what assessment he has made of the effect of the abolition of the requirement for notification of extra-contractual referrals from 1 August on the explicit exclusions from current contracts with trusts for certain interventions(a) on grounds of clinical ineffectiveness and (b) on all other grounds. [39743]
§ Mr. HagueIt is not anticipated that the abolition of the requirement for notification of ECRs from 1 August will have any effect on explicit exclusions from current contracts either on grounds of clinical ineffectiveness or on any other grounds.
§ Mr. MorganTo ask the Secretary of State for Wales if he will list the current system for resolving disputed extra-contractual referral cases; and what proposals he has to revise the disputes procedure in the light of the new guidance letter of 2 July. [39705]
§ Mr. HagueDisputed extra-contractual referral cases are referred to the Welsh Office for arbitration. Details were set out in guidance issued on 31 March 1995. It is not anticipated that these arrangements will be changed.
§ Mr. MorganTo ask the Secretary of State for Wales what provision he is making to consult non-fundholding GPs on the proposed changes in the notification procedure on extra-contractual referrals which terminate the requirement for trusts to seek prior approval from health authorities before providing elective treatment to patients outside existing contracts. [39716]
§ Mr. HagueHealth authorities will be expected to work closely with all GPs in their area to agree suitable arrangements for dealing with extra-contractual referrals for elective treatments following the proposed abolition of the requirement for trusts to seek prior approval.
§ Mr. MorganTo ask the Secretary of State for Wales (1) what arrangements he is making to publicise the changes in the extra-contractual referral system due on 1 August; [39712]
(2) what provision he made for non-fundholding GPs to be notified of the proposed changes in the extra-contractual referral system as regards (a) the termination of the requirement to notify purchasers of emergency or tertiary extra-contractual referrals and(b) the exceptions to the changes. [39714]
§ Mr. HagueHealth authorities, NHS trusts and GP fundholders received formal notification of changes in the extra-contractual referral system in departmental guidance issued on 2 July. In the normal way, health authorities will be expected to ensure that the information is brought to the attention of all general practitioners in their area.
389W
§ Mr. MorganTo ask the Secretary of State for Wales what assessment he has made of the effect of the abolition of requirement for notification of extra-contractual referrals from 1 August on the practice of general practitioner fundholder contracts with trusts requiring prior authorisation in advance of elective tertiary referrals; and if he will make a statement. [39744]
§ Mr. HagueThe abolition of the requirement for prior notification of elective tertiary referrals will apply equally to general practitioner fundholder contracts and those of health authorities.