Editorial: DH must halt QOF plan or risk reforms

In your first fortnightly GP, we reveal exclusive survey results showing that a only minority of practices are better off now than before the 2004 GMS contract.

Most GPs report that their take-home pay is falling, and the most popular cost-cutting measures include reduced locum use, cutting partners’ take-home pay, freezing staff pay and offering fewer services.

It’s difficult to remember a more dramatic fortnight in general practice, as contract talks broke down and the DH threatened to impose plans that included the most radical QOF overhaul yet, which could see every practice losing £15,000.

It’s hard not to conclude, as the BMA did after five months of negotiation, that the DH was asking for too much. A case in point is changing the time allowed for GPs to complete annual checks for indicators covering around a third of QOF from 15 to 12 months. GPs’ workload would inevitably increase in the spring to ensure that patients with reviews due in March did not come in late and those expected in April were not seen early.

Elsewhere, 15% of evidence-backed QOF funding would be transferred to enhanced services for who knows what politically driven whim of the day. The GPC described the ‘paucity’ of the evidence backing government moves to change the Carr-Hill formula, and the DH set out its stall to rid primary care of the MPIG, which 65% of UK practices rely on to top up their income, by 2021.

Is the new health secretary, Jeremy Hunt, responsible for these hardball tactics?

How should the BMA respond?

It’s difficult not to view what has happened with utter bafflement.

The BMA said a deal was close, and it would seem sensible that in any negotiation there would be some give and take on both sides. At the moment it seems that there has been absolutely no concession by NHS Employers, which is negotiating on behalf of the DH.

The stakes are high: is the government willing to risk the failure of its NHS reforms, which it is relying on GPs to lead, because of its intransigence over the new contract deal for 2013/14?

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