Britain: An official handbook > 1977

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Finance
BRITAIN 1977: AN OFFICIAL HANDBOOK
authorities include regional health authorities, area health authorities, boards of
governors and family practitioner committees. Before a commissioner can
investigate, the complaint must have been brought to the attention of the
authority concerned, and an adequate opportunity given for it to investigate
and reply. Matters which are outside his jurisdiction include action taken solely
in the exercise of clinical judgment and the action of general practitioners and
dentists in connection with medical and dental services; these, however, may
be investigated under a separate procedure.
The commissioners report annually to the respective Secretaries of State who
lay the reports before each House of Parliament. The terms of reference of the
Select Committee on the Parliamentary Commissioner for Administration
(see p. 38), who also holds the three posts of Health Service Commissioner,
have been expanded to cover these reports.
In Northern Ireland the Commissioner for Complaints (see p. 70) investi¬
gates complaints concerning the health service, but not the actions of medical
practitioners or other professions supplementary to medicine.
Public expenditure on the health services in Great Britain was about £5,458
million in 1975-76. Most of the cost falls on the Treasury while the rest is met
from the national health service contribution paid with the national insurance
contribution and charges paid by people using certain services. There are
charges for medical prescriptions (except for children under 16 years, expectant
and nursing mothers, women aged 60 and over and men aged 65 and over,
patients suffering from certain medical conditions, war and Service disablement
pensioners, and families with very low incomes, including those receiving
supplementary benefits and family income supplement); for treatment in the
general dental service (but not for examination only or for treatment given to
people under 21 years or women who are pregnant or have borne a child in the
past year); for dentures (except for children under 16 or still at school, and
women who are pregnant or have borne a child in the past year); for spectacles
(except children’s standard spectacles); and for certain other articles. Certain
low income groups are exempt from dental and optical charges (those receiving
supplementary benefit or family income supplement and those receiving free
prescriptions or welfare foods). A limited amount of accommodation may be
made available for hospital patients wishing for privacy, provided that it is not
needed on medical grounds for non-paying patients; a charge for part of the
cost of the accommodation is made. Provision is also made at certain hospitals
for patients to be treated as private patients on payment of the whole cost of
their accommodation and treatment. The Government is, however, planning to
phase out private pay beds in National Health Service hospitals.
Hospital medical staffs are either full-time and salaried, or part-time; part-
time medical officers are usually paid on a sessional basis and are free to accept
private patients. General medical practitioners in the National Health Service
are paid according to the number of patients on their list with adjustments to
reflect differences in work and responsibility; certain practice expenses are also
directly reimbursed.
Dentists providing treatment in their own surgeries are paid on a prescribed
scale of fees according to the treatment they have carried out. Pharmacists
dispensing on their own premises are paid on the basis of the prescriptions they
dispense. Ophthalmic medical practitioners and ophthalmic opticians taking
part in the general ophthalmic service are paid approved fees for each sight test
made; opticians who dispense spectacles are paid according to the number and
type of pairs supplied.