Joint Committee on Statutory Instruments Sixth Report


Memorandum by the Scottish Office Department of Health


  The Committee considered the above instrument on 24 June 1997 and requested a Memorandum on the following points:

  1. Regulation 4(1)(b) requires the relevant Health Board, if it determines to refuse recognition as a fundholding practice, to include in the notice of its determination that it gives to the members of the practice a statement of its reasons and to inform each member of his right of appeal (under Regulation 5) to the Secretary of State. Explain why this obligation to inform of the right of appeal is excluded in the case of an application for recognition as a purchasing co-operative (by contrast with applications for recognition as a standard fundholding practice or a primary care purchasing practice).

  2. Regulation 21(3) refers to a "preparatory period" (in relation to which management expenses to a greater percentage are allowed). Explain what this period is, in particular its duration, and identify and definition of it.

  With regard to the first point, a purchasing co-operative is intended to be a working partnership between the GPs and the Health Board and as such would not work in practice unless both parties were committed to it. If a Health Board refused to grant recognition for any reason it would not be appropriate for there to be a right of appeal to the Secretary of State against such a decision since if such an appeal were granted it would in effect force a Health Board to work collaboratively with a group of GPs.

  With regard to the questions raised on Regulation 21(3), this is not a new provision. Preparatory Management Allowances have been available since the introduction of fundholding in 1991. The preparatory period is a period of time during which the members of the practice must show that they are capable of managing their medical practices in general in an effective and efficient manner and that they have, or have access to, such equipment (including computers) and expertise (including appropriate staff resources) as are necessary to assist them to manage an allotted sum effectively and efficiently. The preparatory period is usually one year although Health Boards have discretion to extend it, if they think a practice needs more time to prepare, or reduce it if they consider the practice to be ready to undertake efficient and effective management of the fund. We are not aware of any formal definition of the preparatory period, but the working definition is - the period required to allow for:

    -    data collection by the practice/Health Board on treatment/referral patterns and prescribing costs;

    -    acquisition of and familiarisation with a new computer hardware/software;

    -    appointment and training of staff for managing and administering the fund;

    -    data verification and valuation of fund allocation by Health Board; and

    -    contract discussions.

30th June 1997

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