Full reaction to GMS 2013/14 decision

GP leaders warned the government would 'live to rue the day' after the DH ignored most of the BMA's concerns as it set out final plans for the 2013/14 for England.

Dr Peter Holden: DH will live to rue the day
Dr Peter Holden: DH will live to rue the day

The final plans for the GMS contract published on Monday include axing MPIG over seven years from 2014 and overhauling the QOF.


GPC negotiator Dr Peter Holden said: ‘The government will live to rue the day. They need to understand we are workload saturated and if they don’t cover our overheads they can expect less and less from us.

‘We will comment in detail when we read the document.’

Asked if the DH had sent the BMA details of the contract changes before making them public, he said: ‘No, which just shows the contempt it has for us.’

Wessex LMC

Wessex LMCs' chief executive, Dr Nigel Watson said: ‘It is an interesting political decision. I think it risks GPs’ willingness to engage in clinical commissioning. It will have a negative impact [on clinical commissioning]. They [CCGs] need clinical engagement.’

On the clinical changes to the contract, he said: ‘Some practices will either stop doing things or they will not sign up to some of the new stuff.

‘We have 2,200 patients with hypertension and we struggle to get some to 150/190 mmHg. We will now have to see them more often. It will mean more work or we will lose funding.

‘GPs will get a pay cut because GPs expenses are rising by more than 1.32%. It is going to be a tough time for practices.’

Manchester LMC

Manchester LMC secretary Dr John Hughes said: ‘Any changes they have made are completely minimal such as deferring some of the QOF changes. The whole thing is just absolute rubbish. This thing about the 1.32% uplift allowing us to give our staff 1% rise, doing that will give GPs yet again a drop in income. The calculation was that we needed 2.3% or 2.4% just to break even, never mind to give someone a rise. There are going to be serious difficulties because they are taking away the organisation points which we used to pay staff to do the organisational work. For dementia, they are talking about early screening. There aren’t the services in secondary care to refer people to.

‘It completely misunderstands the nature of primary care because it assumes you don’t case manage or assess patients and don’t continual monitor them and that you refer them when appropriate. It assumes you refer straight away.

‘Increasing the thresholds is dangerous and it is not necessarily in patients’ interests. It means to achieve that you will have to target and treat more elderly people with hypertension because there is a one size fits all target. If you overmedicate elderly people with hypertension you risk them becoming dizzy when they stand up and it increases the chance of falls and hip breakages.

‘I think it is extremely unlikely that there will be calls for industrial action because we saw what will happened with pensions. It may mean that GPs will have to focus on their core business and may not pick up areas of the QOF.’

NHS Employers

NHS Employers chief executive Dean Royles said: ‘After months of seeking a negotiated agreement, we recognise why the government has moved to announce its decision and to put patients first.

‘These changes to the GP contract follow months of seeking a negotiated agreement by NHS Employers and a considerable further consultation over the last few months by the DH. We were clear throughout of our willingness and availability to negotiate.

‘The NHS Employers organisation ambition has always been to negotiate fairly to get the best deal for patients. Today's announcement reflects many of the areas where we tried to take the negotiations. Our aim was to ensure that more patients receive the range of service and quality of care provided by the top performing GP practices. That must surely be the ambition of all parties. I'm therefore disappointed that, although we tried incredibly hard, a negotiated settlement just wasn't possible. This is even more disappointing as we had reached agreement with trade unions representing over one million other NHS staff on changes to their pay.

‘The government's decision to uplift the overall GP contract by 1.32% clearly seeks to ensure that increases in the take home pay of staff working in GP practices are consistent with the 1% pay increases that other staff working in the public sector will receive.

‘We therefore understand why the government has taken these decisions given the need to address a range of patient issues. I know the GPC will be frustrated by the announcement but we owe it to our patients to now work together to implement these changes to ensure they improve the quality of care provided to patients. I do hope the GPC will commit to that.’

The DH

Health secretary Jeremy Hunt said: ‘Improving care for patients has always been my priority.

'The GP contract needs to change to make sure the excellent care enjoyed by some patients is more consistent across the country.

‘Providing better treatment for people with long term conditions helps save lives and I know GPs will rise to the challenge to make sure standards of care in this country are world class and continuously striving to improve.

‘We have listened to GPs and stakeholders and made some changes to our proposals to reflect these views and now feel we are in the right place to go forward.

‘I am committed to ensuring that we improve quality of life for people with long-term conditions, and I want GPs to lead this change from within their own practices.’

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