Exclusive: GPs lose right to first refusal on vacancies

GPs have lost any right to preferred-provider status in offering their services to PCTs, according to legal advice.

North Manchester PCT has been advised by Hempsons, its solicitors, that its obligations under European Union law require it to advertise any GP vacancy.

This obligation abolishes GPs' right of first refusal enshrined in the DoH's 2003 guidance 'Delivering Investment in General Practice'.

It appears to back the decision of a Kent PCT to put a practice in one of England's most under-doctored areas out to tender under APMS, dashing the partnership hopes of the salaried GP working there (GP, 14 July 2006).

Rachael Young, associate director of primary care at North Manchester PCT, said in a letter to Manchester LMC: 'The PCT has been advised that if it were not to advertise ... a decision could be challenged by an aggrieved contractor who could have provided the service.

'A competitive process will be required where a number of expressions of interest are received following the advert.'

Dr Peter Fink, Manchester LMC secretary, said it looked 'sadly' like the end of the road for preferred-provider status.

Last week the GPC was seeking legal advice. A GPC spokesman said: 'There is no legal requirement to advertise vacancies but the EU procurement principles apply. The big question is how strong the imperative is to follow those principles. Until this is tested in court, there may be no clear answer.'

North Manchester PCT is the most under-doctored area in England according to this year's primary care White Paper, with 40.6 GPs per 100,000 population.

The PCT admitted that its position was 'in tension' with the 2003 'Delivering Investment in General Practice' guidance but said that it agreed with later guidance in 2005 'Procurement Guide: alternative provider medical services'.

Last month delegates at the LMCs' conference voted unanimously in favour of existing providers being offered first refusal before alternative providers were given the chance to bid for GP services.

Dr George Rae, GPC member for Tyne and Wear, said he was 'very disappointed but not surprised' by the advice: 'This is further evidence of the application of APMS going way beyond its original intention.'

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