Darzi must back the entrepreneurial GP spirit

Two years ago the GPC drew up a shortlist of its negotiating priorities. GP has used this as the basis for surveying GPs on what they think the number-one priority for the GPC should be.

This week we can reveal the results of the 2008 survey after a poll of 107 LMCs representatives was taken at this month's LMCs conference in London.

In 2006 it was the workload implications of change to the quality framework that you most sought to manage.

In 2007 as the realities of zero pay awards began to bite, it was an inflation pay rise that you most sought to be awarded. So what conclusions should we draw from the 2008 results backing MPIG protection?

Earlier this year the DDRB recommended that core pay rises should cut correction factors. About 90 per cent of practices rely on MPIG, so it is an issue of huge importance to the profession.

As the DoH considers the GPC's protest about this move, it would appear that health minister Lord Ara Darzi is about to recommend the phasing out of the MPIG in his NHS review due out next week.

If the DoH does indeed consult the profession about the future of the MPIG what should it expect to learn?

Well, one glance at our survey would tell it that 32.7 per cent of GPs thought MPIG protection was the number-one priority for the GPC in 2008. A close second was an inflation pay rise and the other four priorities were some way off. What does this tell us?

Well, health secretary Alan Johnson may be certain that practices will not be closed as a result of government policy, but practices are far from convinced about their survival.

The national media may have an obsession with criticising GPs over pay, but it is not increasing income that is concerning you, it is maintaining it.

If GP had one message for Lord Darzi, it would be to value general practice, not threaten its survival.

There is hope. Last week, former DoH adviser Professor Chris Ham, professor of health policy and management at the Health Services Management Centre at the University of Birmingham, predicted that pilots of GP-led integrated service organisations free of Payment By Results would be a major feature of the Darzi review.

These organisations would involve a network of high-performing practices pulling work from hospitals with greater practice-based commissioning freedoms.

It is this sort of initiative, appealing to the entrepreneurs and innovators that so characterise general practice, that should be encouraged. Not the threat to the MPIG that currently casts a shadow across so many practices.

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