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General Practitioners

Volume 472: debated on Monday 3 March 2008

To ask the Secretary of State for Health what estimate his Department made of the cost of the new contract for general practitioners that came into effect in April 2004 before its introduction; and how much it cost in each subsequent year. (188311)

Negotiators at the outset of the original nGMS contract agreed to a guaranteed 36 per cent. increase in minimum levels of investment over the three year period ending 2005-06 through the Gross Investment Guarantee to support the introduction of a new general practitioner contract that delivered higher quality care and an increased range of services for patients.

In costing the entirety of new contract costs including spend against actual resources allocated to primary care trusts (PCTs) over the same period, spend was actually 52 per cent. Measurement of spend against the Gross Investment Guarantee (the minimum level of investment agreed by negotiators) should not be confused with spend against actual resources allocated to PCTs.

Actual spend in each year and the guaranteed minimum investment are shown in the following table.

Spend on primary medical care services compared with the Gross Investment Guarantee

£ million

2002-03

2003-04

2004-05

2005-06

2006-07

Gross Investment Guarantee

n/a

5,611

6,211

6,918

n/a

Spend on primary medical care services

5,084

5,811

6,957

7,734

7,757

n/a = not applicable

Note:

Actual spend in 2002-03 was £4,893 million but to allow comparability with the £191 million expected spend on enhanced services under the new contract, £191 million was added to produce the 2002-03 baseline figure.

To ask the Secretary of State for Health (1) with reference to the answer to the hon. Member for South Cambridgeshire of 30 October 2007, Official Report, column 1222W, on general practitioners, what progress the NHS Next Stage Review has made in examining the different domains of the Quality and Outcomes Framework; what interim findings have emerged from the Review; whether he expects changes to be made to the process for reviewing the Quality and Outcomes Framework for the (a) 2009-10 and (b) 2010-11 financial years; and if he will make a statement; (189439)

(2) if he will make it his policy that reviews of the Quality and Outcomes Framework take place for each new financial year;

(3) when he expects the review of the Quality and Outcomes Framework for the 2009-10 financial year to begin; and if he will make a statement.

The Quality and Outcomes Framework (QOF) is kept under constant review. Changes to the QOF are made as part of wider general medical services contract negotiations between NHS Employers and the General Practitioners Committee, which provides an opportunity to make changes in each new financial year.

Lord Darzi’s interim findings from the Next Stage Review were published on 4 October 2007. The interim report announced the development of a strategy for primary and community care services. A copy of the interim report is available in the Library. As part of the development of this strategy the Review will consider how to reshape incentives to provide a stronger focus on health outcomes and continuous quality improvement; whether there should be an independent process for setting and reviewing outcomes measures in the framework; and whether there should be greater flexibility for primary care trusts in setting outcomes that reflect local needs and priorities.

The NHS Next Stage Review is ongoing and the outcome will be published later this year.

To ask the Secretary of State for Health how many (a) GP surgeries and (b) health centres have closed in each of the last 10 years. (180385)

The Department does not collect centrally the numbers of closures of general practitioner (GP) surgeries or health centres. These data are held locally by primary care trusts.

However, we do collect data on numbers of GP practices, and practitioners, at a given date for each year. These are set out in the following table:

Number of GP practices in England, as at 1997-2006

Total GP practices

Total number of GPs1

1997

9,102

28,046

1998

9,090

28,251

1999

9,034

28,467

2000

8,965

28,593

2001

8,910

28,802

2002

8,833

29,202

2003

8,833

30,358

2004

8,542

31,523

2005

8,451

32,738

2006

8,325

33,091

1 Excluding GP registrars and GP retainers

Note:

Data as at 1 October 1997-99, 30 September 2000-06

Source:

The Information Centre for Health and Social Care—General and Personal Medical Services Statistics