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Nhs General Medical Practices In Inner London

Volume 417: debated on Monday 9 February 1981

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2.45 p.m.

My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government how many National Health Service general medical practices in Inner London have less than 1,000 patients and how many doctors in those practices are over 70 years of age.

My Lords, on 1st October 1980, there were 58 general medical practices in Inner London with less than 1,000 patients providing unrestricted general medical services. Twenty-four doctors in those practices were aged 70 or over. A further 36 practices provide restricted services, mostly to staff of hospitals or institutions. Two doctors in those restricted practices were aged 70 or over.

My Lords, I am obliged to the noble Lord for that information. Is the noble Lord aware that more doctors with small lists of patients, more doctors with very large lists of patients, more doctors of 70 years of age and more doctors working single-handed are to be found in Inner London than anywhere else in the country? Is this not largely due to the fact that lists of 1,000 patients enable a doctor to claim the basic allowances permitted under the National Health Service—which means that, having got the basic allowances for the 1,000 patients, they are then free to go and earn additional income outside the National Health Service?

My Lords, that is absolutely true. There is nothing to stop a National Health Service doctor from having private patients as well as National Health Service patients. That has always been the case and I do not think it has been suggested that it should change.

My Lords, may I ask the Minister this: Does not this mean that there must be a large number of people in Inner London who are not being properly cared for from a health point of view or not being cared for at all; or who, if they want care, have to go privately? It seems that everything points to that; and that in areas like that of this House, in Westminster, Kensington and Chelsea, 1 in 8 of doctors in general practice is over the age of 70 and 1 in 6 has fewer than 1,000 patients. Is this not quite deplorable? I should like to know whether the Government are proposing to do anything about it.

My Lords, the noble Lord is no doubt aware that the whole question of primary health care deficiencies in Inner London—and we realise that there are some—is currently being considered by a study group established by the London Health Planning Consortium under the chairmanship of Professor Donald Acheson, Professor of Clinical Epidemiology at the University of Southampton. The report is expected in the next few months and will be studied with interest.

My Lords, would the noble Lord not agree that the age of 70 is rather an arbitrary figure to fix for a doctor's retirement?