asked the Secretary of State for Social Services (1) if he will list those matters in respect of which general practitioners receive indirect expenses; and if he will quantify the average value of each of the same to individual general practitioners;(2) what instructions he has given to family practitioner committees in relation to the direct and indirect expenses of part-time general practitioners; and if he will make a statement.(3) pursuant to his reply of 25 March,
Official Report, column 97, and 4 April, Official Report, column 767, if he will list and describe in the fullest reasonable particularity the nature and value of the individual expenses incurred by general practitioners.
I shall let my hon. Friend have replies as soon as possible.
asked the Secretary of State for Social Services what are the maximum fixed expenses for which general practitioners are eligible under section 63 of the National Health Service Act 1977; and if he will list the same.
I shall let my hon. Friend have a reply as soon as possible.
asked the Secretary of State for Social Services what is the top rate seniority allowance for general practitioners; what is the eligibility of older general practitioners to obtain further superannuation; at what age such incentives commence and cease; and what is the effect on the eligibility of general practitioners for such incentives if they obtain limited commitment.
The top rate seniority allowance for general medical practitioners is currently £4,375 per annum. A lower allowance first becomes payable after 11 years on the medical register and seven years as a National Health Service principal. Seniority allowance ceases to be payable at age 72. Payment of the allowance to a doctor who has a limited commitment depends on the nature of the commitment.General practitioners may retire at any time on reaching age 60. If they retire and again practise, even after 24 hours, as principals in the National Health Service, any pension payable will be reduced so that post-retirement earnings plus pension do not exceed pre-retirement earnings. While re-employed, retired doctors continue to pay contributions to the NHS superannuation scheme and earn further pension rights up to age 70. However, general practitioners who retire for the first time at age 65 or over may be re-employed without their pension being liable to reduction. In such a case, the re-employment is not superannuable and no further pension rights may be earned.
asked the Secretary of State for Social Services if he will identify and list, together with the sums payable in respect of each, the basic allowances, seniority allowances and other fees or allowances for which general practitioners are eligible
The fees and allowances, together with the rates payable at 1 November 1984, are as follows:
| Rates at 1 November 1984 £ | ||
| 1. Basic Practice Allowance: | ||
| (a) Full rate | 6,760 | per annum |
| (b) First 100 patients | 1,360 | per annum |
| (c) Each patient above 100 to 999 | 6 · 00 per annum | |
| (d) Leave payment | 1,352 | per annum |
| 2. Additions to Basic Practice Allowance in respect of: | ||
| (i) Pratice in a designated area | ||
| Type 1 | 2,095 | per annum |
| Type 2 | 3,195 | per annum |
| (ii) Practice as a member of a group | 1,175 | per annum |
| (iii) Seniority | ||
| First payment | 1,620 | per annum |
| Second payment | 2,760 | per annum |
| Third payment | 4,375 | per annum |
| (iv) Vocational training | 1,450 | per annum |
| (v) Employment of an assistant (full time) or where the principal (or in a partnership all principals) receive an addition as the practice is in a designated area | 4,410 | per annum |
| 3. Payments for out of hours responsibilities: | ||
| (i) Supplementary practice allowance | ||
Rates at 1 November 1984 £
| ||
| (a) Full rate | 1,345 | per annum |
| (b) First 100 patients | 265 | per annum |
| (c) Each patient above 100 to 999 | 1·20 per annum | |
| (ii) A Supplementary Capitation fee for each patient in excess of 1,000 on the practitioner's list (or in excess of 1,000 per practitioner on the combined list of practitioners, practising in partnership) | 1·31 per annum | |
| (iii) A fee for a night visit | 14·90 per annum | |
| 4. A fee for an item of service carried out for reasons of public policy: | ||
| (i) Vaccination and immunisation | ||
| Fee A | 2·20 per annum | |
| Fee B | 3·20 per annum | |
| (ii) Cervical cytology test | 6·40 per annum | |
| 5. Fees for provision of contraceptive services: | ||
| (i) Ordinary | 8·55 per annum | |
| (ii) Intrauterine device | 28·70 per annum | |
| 6. Fees for the provision of maternity medical services: | On obstetric list
| Not on obstetric list
|
| (i) Complete maternity services | 100·00 | 58·35 |
| (ii) Ante-natal care: | ||
| (a) Woman booking up to the 16th week of pregnancy | 54·00 | 31·50 |
| (b) Woman booking from the 17th week to the 30th week of pregnancy | 40·50 | 23·65 |
| (c) Woman booking from the 31st week of pregnancy | 27·00 | 15·75 |
| (iii) Miscarriage | 33·35 | 20·85 |
| (iv) Care during confinement | 23·00 | 13·35 |
| (v) Complete post-natal care | 23·00 | 16·35 |
| (vi) Partial postnatal care | ||
| (a) Each attendance subject to a | 3·05 | 2·15 |
| maximum of | 15·25 | 10·75 |
| (b) Full postnatal examination | 7·75 | 5·60 |
| (vii) Second practitioner called in to give anaesthetic | 21·30 | 21·30 |
| 7. A fee for the treatment of a temporary resident who: | ||
| (i) Expects to remain in the district for not more than 15 days | 4·90 | |
| (ii) Expects to remain in the district for more than 15 days | 7·35 | |
| 8. A fee for treatment given by a practitioner in an emergency not in his list and not eligible to be treated as a temporary resident: | ||
| (i) Emergency consultation | ||
| (a) Involving a night visit | 14·90 | |
| (b) Other | 12·75 | |
| (ii) Minor surgical operation requiring anaesthetic | 12·75 | |
| (iii) Treatment of fracture | 12·75 | |
| (iv) Reduction of dislocation | 12·75 | |
| (v) Administration of general anaesthetic | 21·30 | |
| 9. A payment in cases in which a practitioner is required to provide the services of a second practitioner for the purposes of administering general anaesthetic except in connection with maternity medical services | 21·30 | |
Rates at 1 November 1984 £
| ||
| 10. | ||
| (i) Fee for the arrest of dental haemorrhage or for the provision of after care | 12 · 75 | |
| (ii) Fee for the removal of plugs and/or stitches only | 8·70 | |
| 11. A fee for immediately necessary treatment given by a practitioner under paragraphs 6(3) or 4(4) of his terms of service | 4·90 or 7·35 | |
| 12. Postgraduate training allowance | 605 | |
| 13. Payments in respect of the Trainee Practitioner Scheme | ||
| (i) Training grant | 3,160 | per annum |
| (ii) Allowance for additional motor vehicle: | ||
| (a) For one year's full-time training | 2,241 | |
| (b) For two years' part-time training (for each year) | 1,398 | |
| (iii) Trainees salary and board and lodging — approx. maximum payment (dependent on last hospital post) | 10,270 to 16,917 | |
| (iv) London Weighting | ||
| (a) London Zone | 807 | per annum |
| (b) The Fringe Area | 149 | per annum |
| 14. Payments under the Doctors' Retainer Scheme | 21·35 per session | |
| 15. Initial Practice Allowance | Maximum allowance | |
| (i) Type A First year | 11,310 | |
| Second year | 7,540 | |
| Third year | 3,770 | |
| Fourth year | 1,885 | |
| (ii) Type B First year | 18,850 | |
| Second year | 7,540 | |
| (iii) Type C First year | 9,900 | |
| Second year | 7,425 | |
| Third year | 4,950 | |
| Fourth year | 2,475 | |
| (iv) Type D Guaranteed net income: | ||
| (a) First doctor | 28,690 | |
| (b) Two partners joint net income | 50,760 | |
| 16. Payments in respect of the supply of drugs and appliances | Various | |
| 17. Inducement payments | Various | |
| 18. Additional payments during sickness | *213·50 per week | |
| 19. Additional payments during confinements | ||
| 20. | ||
| (a) Prolonged study leave allowance | 31·40 per week | |
| (b) Educational allowance locum allowance | Up to a maximum of 213·50 per week | |
| 21. Payments under the Rent and Rates Scheme | Various | |
| 22. Payments under the Ancillary Staff Scheme | Various | |
Rates at 1 November 1984 £
| ||
| 23. Related Ancillary Staff Allowance | 1,760 | per annum |
| 24. Improvement Grant | Various | |
asked the Secretary of State for Social Services how many general practitioners operating within the National Health Service are over the age of 65 years.
The number of unrestricted principals in England practising in the National Health Service aged 65 and over at 1 October 1984 was 1,189.
asked the Secretary of State for Social Services how many and what representations he has made to the General Medical Services Committee and elsewhere about a fixed retirement age for general practitioners; what was the response; when he will next make representations; and if he will make a statement.
We have made no representations and no decision yet about a fixed retirement age.