DoH threatens a third pay freeze

GPs could face a third freeze on global sum and quality payments in 2008/9 if there is no agreement with the DoH on efficiency savings and service levels.

GPC chairman Dr Laurence Buckman warned that this would create a 'very real risk of a return to the disastrous pre-contract morale problems'.

In evidence to the Review Body, the DoH said any uplift to practice income should be dependent on either 'changes' to GP income streams, 'efficiency gains by general practice', 'movement' on the MPIG or 'improve- ments' to the quality framework.

The DoH also wants a balancing mechanism to increase the amount of profit GPs reinvest, which it claims has fallen as a proportion of profits despite GP income increasing by 55 per cent between 2003/4 to 2005/6.

The evidence says: 'The government expected a certain level of profits to be invested back into GP services, to bring about further improvements in services for patients. This has not been the case.'

The DoH also accuses GPs of driving down their costs and maintaining profits, particularly in response to successive pay freezes since 2006/7, by squeezing practice nurse pay and employing more salaried GPs.

However, Dr Buckman described the DoH evidence as an insult.

'GPs are investing heavily in both staff and practices,' he said. 'The areas where expenses fell were business expenses and car and travel costs, along with depreciation on capital assets.'

He said GPs were investing in patient services but were sometimes prevented from doing more by primary care organisations.

The DoH argues that the number of hours worked per week has fallen by 17 per cent, GP list size is down by 12 per cent and consultations are down by 30 per cent. It claims that time spent on home visits has been reduced by 63 per cent and on telephone consultations by 31 per cent.

But Dr Buckman said GPs were working harder and that a further pay freeze could see more retiring or leaving the profession. He said that the 2005/6 workforce figures showed that the number of GP providers was at the lowest level since 2000.

'These are the doctors who contract to provide general practice services and the NHS can ill afford to lose them,' added Dr Buckman.

However, the DoH says there is no evidence to suggest that there are any problems with recruiting or retaining GPs.

Contentiously, the DoH also estimates that GP profits will rise by between 1 and 2 per cent in 2006/7 and by up to 1 per cent in 2007/8, despite predictions from accountants that profits will fall by 7 per cent in both years.

neil.durham@haymarket.com

DoH evidence

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