§ Mr. OatenTo ask the Secretary of State for Health what steps his Department has taken to ensure that prostheses users are able to obtain out of area treatment after April 1999 if their local limb centre cannot meet their needs for comfort, capability and cosmesis. [73182]
§ Mr. HuttonThe arrangements for commissioning patient services from 1 April 1999 will ensure that all referrals to National Health Service hospitals are covered by either the new long-term service agreements or the new arrangements for access to specialised services.
Where there are consistent patterns of referrals to a service, whether a specialised service or more locally, these are being built into service agreements. Cases that do not fit this will be covered by the new arrangements for out of area treatments.
All out of area treatment referrals will be covered by the standards for quality and effectiveness specified in the main commissioner's service agreement and will be treated under the same agreements and on exactly the same basis. Prior approval will not be required for out of area treatment.
Under the new arrangements, general practitioners and consultants will retain the clinical freedom to refer patients for the most appropriate treatment. However, they should explore fully the scope to make maximum cost-effective use of local NHS facilities before contemplating recourse to non-NHS provision.
The decision to commission services provided by non-NHS facilities will continue to be made locally and will be made in the interests of the patient.