To ask the Minister of Health whether he has considered reviewing the policy on enabling GPs to issue a NHS prescription based on private consultations.

As independent contractors and clinical professionals, GPs are responsible for making appropriate decisions about the treatment, care, and management of their individual patients.

Individuals choosing to procure healthcare privately are effectively stepping outside of the health and social care (HSC) system. In these circumstances, there is no obligation on GPs to provide pre and/or post treatment support. Therefore, it remains important for individuals wishing to avail of private healthcare to ensure that all pre and post treatment support costs are included in the overall package of care procured from the private healthcare provider. In instances where any ongoing treatment and medication is recommended, but is not provided, by the private provider as part of the private service then individuals should be prepared to meet any associated costs.

GPs remain responsible for clinical decisions regarding the care of individual patients and as such they should exercise their clinical judgement prior to providing any pre and/or post treatment support for individuals availing of private healthcare.

Whilst there is no obligation on GPs to provide such support, in instances where a GP considers that the support being requested is clinically appropriate, falls within their area of competence, does not breach the terms of their GMS contract or indemnity cover, and is in keeping with the General Medical Council (GMC) standards on prescribing and Good Medical Practice then they may choose to provide this support or continue to provide this support.

However, there may be additional factors to consider in specific circumstances where a GP is being asked to provide an HSC prescription to a patient based on the recommendation of a private practitioner.

If a GP considers that ongoing prescribing of a medicine is appropriate for supply through the HSC service, they are content that the treatment falls within their clinical remit and that if necessary appropriate shared care arrangements have been agreed with the private practitioner, the HSC prescriber and the patient/carers, then under the HSC terms of service they may issue an HSC prescription. In reaching this decision the GP should apply the same criteria had the request originated within an HSC clinic, such as consideration of the Northern Ireland Formulary and national recommendations.

By accepting the advice of the private practitioner and proceeding to sign the prescription, the GP is accepting clinical responsibility for this decision.

There are currently no plans to review the Department’s position. The principle in which individuals procuring private healthcare are effectively steeping outside the HSC remains appropriate. Furthermore, there is a clinical and legal responsibility on the prescriber as they must be able to prescribe within their own level of competence and scope of practice.