Six-month delay could be fatal for GP contract
pharmafile | October 28, 2003 | News story | |
The crisis surrounding the proposed new GP contract has deepened after doctors refused to be "stampeded" into accepting a new contract, which many say contain "disastrous flaws".
Local GP representatives have narrowly voted in favour of a six-month delay to allow the contract to be revised, but there is no clear consensus on how to salvage the miscalculated proposals, or what could replace them.
Birmingham GP Fay Wilson said at the BMA vote: "This product is not good enough. It is not fit for its purpose. We are not going to be bullied into accepting something that will ruin our profession".
A huge flaw in calculations of how much GPs would earn for providing services under the new agreement threw the contract into crisis just days before doctors were due to vote to accept or reject the new terms.
The new contract proposes an average pay rise of 26% over three years, but as many as 70% of GPs could actually be worse off under the new funding formula, which links payment to the number and quality of services provided.
The NHS Alliance says if the negotiations take the full six months, the new contract will have to be abandoned altogether, predicting that many GPs will opt for the alternative Personal Medical Services (PMS) contract instead.
The Alliance says negotiators must abandon the funding formula completely in order to salvage the underlying principle of the contract, which the organisation and many GPs support.
The DoH has guaranteed no GP would lose out under the new contract, but local GP leaders, with the backing of the NHS Alliance, have now said the Carr-Hill formula should either be refined or scrapped altogether in favour of new system.
Health Minister John Hutton has also warned GP negotiators that time is running out for Parliament to incorporate the contract into the Health and Social Care Bill.
Dr John Chisholm, Chairman of the BMA's General Practice Committee, echoed concerns that excessive delays could jeopardise the whole contract, but said he would support any efforts to reach agreement.
"Let me be very clear. I have no intention whatsoever of rushing into a ballot on this contract that would result in a 'no' vote", he said.
"Rejection of the new GMS contract would also undermine the prospects of achieving a UK-wide contract something that GPs in all four countries wish to see and could well lead to the end of national negotiating arrangements and a move to local arrangements, to practice being played against practice".
PMS make up over a third of all GP practices in the UK, but Dr Chisholm said many feel it is inferior and less equitable than a central General Medical Service contract
The NHS Alliance said a transitional funding arrangement should to be implemented, with payments based on the same methodology as PMS.
"[This] solution would be simple to implement and would satisfy all parties", said NHS Alliance Chairman Dr Michael Dixon. "It would bring government investment into general practice in return for improved quality. And it would provide the breathing space needed to get the funding formula right".
Doctors operating under PMS have failed to receive sufficient information about the contract, said the Alliance, specifically, about their future under PMS and their rights to return to the GMS system.
