£5m GP practice deal marks 'radical change'

A £5 million contract for a private firm to run a GP practice in Dagenham, Essex has been hailed as 'a radical shake-up of GP services' by the DoH.

Care UK won a contract last week with Barking and Dagenham PCT to run a 7,000-patient surgery and a 100-consultations-a-day walk-in centre on the same site.

Under the contract, the practice will take part in the quality framework and payments are based on a score of 950 points. If it achieves more, it will be paid more, but there was no suggestion payments would be cut for a lower score.

The practice will grow to its full size over two or three years and is expected to start with around 1,000 patients. It will eventually employ three GPs and seven nurse practitioners.

A DoH spokesman is understood to have said it demonstrates that prime minister Tony Blair was carrying through 'his belief that bringing in private firms is the only way to improve GP services'.

GPC leaders said this underlying policy was more worrying than the fact that a private firm had won a contract.

GPC deputy chairman Dr Laurence Buckman said: 'Some contracts were inevitably going to be given to private firms where no one else was prepared to do the work. But the solution is to make it more attractive to existing GPs.

'What is saddening is the government's determination to focus its efforts on competition with existing services, rather than to look at better ways of improving care for patients who have found access difficult.

'The DoH may believe the only way to improve GP services is competition, but doctors are in the business of providing high-quality care for their patients rather than operating in a market place which may not always be driven by patients' needs.'

Some GPs believe the deal is not profitable enough to attract a private firm on its own merit, and is simply a way to control practice-based commissioning (PBC) budgets.

Care UK runs an independent-sector treatment centre in Manchester and is in the process of establishing one in London.

Dr Kambiz Boomla, City and Hackney LMC secretary, said: 'I think they want the PBC budgets to consolidate a base in general practice that gives them access to secondary care budgets, which is where the big returns will come.'

Carl Hughes, operations director for clinical services at Care UK, said the practice would be the same as any other and that it would be scrutinised to ensure it did not act in an unfair way.

A DoH spokesman said: 'The standard of care delivered by the provider must be at least equivalent to that provided by the NHS. The provider needs to meet a range of standards enforceable through law with penalties and the prospect of contract termination should it fail to meet those standards.'

- Opinion, page 23.

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