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Medical Personnel (Domiciliary Visits)

Volume 972: debated on Tuesday 30 October 1979

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asked the Secretary of State for Social Services if he will take steps to introduce regulations to require a certificate from general practitioners in respect of domiciliary visits made by hospital consultants giving a specific declaration that the patient was unable for medical reasons to go to the out-patients clinic.

No. The terms of service of consultants already provide that a domiciliary consultation shall be made at the request of the general practitioner, and normally in his company, to advise on the diagnosis or treatment of a patient who on medical grounds cannot attend hospital. I would expect employing authorities to satisfy themselves that a payment is justified, and no further provision seems necessary.

asked the Secretary of State for Social Services if he will take steps to introduce regulations to enable senior registrars to undertake domiciliary visits.

Domiciliary consultations are intended to provide a service by consultants—or appropriately authorised medical assistants—in circumstances where patients cannot attend hospital. For this reason it would normally be inappropriate for practitioners in the training grades to undertake these visits, and I do not therefore intend to extend this service in the way suggested.

asked the Secretary of State for Social Services why there has been a rise leading to 446,944 domiciliary visits by hospital consultants at a cost to the National Health Service of £7 million.

The data available centrally show that in 1978 the total number of domiciliary consultations by consultants in England and Wales increased by 2·4 per cent. over 1977. This reflects an increasing number of visits by geriatricians to the growing proportion of elderly people in the community and the increased emphasis on services for them.

asked the Secretary of State for Social Services if he will publish in the Official Report the number of cases in each of the past three years where fees for domiciliary visits have been disallowed when checked by the North-West Thames regional health authority.

This information is not held centrally. The hon. Member may like to contact the regional health authority direct.

asked the Secretary of State for Social Services if he will publish in the Official Report the sums included in the remuneration of hospital consultants for domiciliary visits in each of the past five years.

No specific data about the amounts paid to hospital consultants for domiciliary visits over the last five years are available centrally. Details on the number of domiciliary consultations by consultants were collected for England and Wales in 1976, 1977 and 1978, and are shown in the table below.

197619771978
Total number of visits (England and Wales)418,228436,618446,944
Normal fee paid per visit (£)10·9010·9012·30