General practitioners' practice expenses.

General practitioners are unlikely to receive the exact level of remuneration recommended in the 16th report of the doctors' and dentists' review body' even if the level was accepted in full by the government and implemented from 1 April. This alarming sounding position is so because general practitioners' remuneration is a series of fees and allowances designed to produce an average income across all unrestricted principals and would be realised in gross terms only if changes in volume (including increases in the number of general practitioners) were as expected by the review body. It will be achieved in net terms only if the amounts set aside for practice expenses turn out to be an accurate forecast of actual expenditure. The term "practice expenses" is used here to refer only to those expenses which fall to be met from gross fees and allowances and excludes those reimbursed directly to general practitioners by family practitioner committees-for example, it excludes the 70% of staff salaries which qualifies for direct reimbursement but includes the 300/o which does not. For both gross income and practice expenses to combine to yield the desired average level of net income would therefore be unlikely if not impossible. The possibility of compensating-errors occurring in the two variables such as expenses being higher than expected while gross income is overachieved may -result in a misleading level of accuracy, and nobody should underestimate the difficulty of the review body's task in setting fees and allowances to achieve its stated intention.