After just three weeks in his new role as health minister, Mike O'Brien finds himself having to defend this year's controversial patient survey. The BMA estimates millions of pounds have been stripped from general practice - despite primary care again receiving glowing praise from the survey.
Any hope the new minister will be less of a GP-basher than his predecessor, Ben Bradshaw, quickly faded when Mr O'Brien talked to GP newspaper about the survey's future.
Describing the five-figure losses many practices face as 'actually quite small', Mr O'Brien not only insists the methodology of the survey was sound, but says GPs did not do enough to encourage patients to respond to the 49-question postal survey.
'We do expect GPs to respond to make sure their response rate is high, and some are, and others are not doing so,' he says.
'There's no point having an expensive survey like this and then doing nothing about it especially financially. It is now a matter for GPs to respond to what patients are saying.'
The new minister concedes that the length of the survey may be the reason some individual practices had very low response rates. 'It is an eight-page questionnaire and that is why, in some cases we've seen a low number of responses,' he says.
In fact, GP found nearly a third of practices' results for the disputed advanced booking question were outside the accepted statistical limit. But the minister does not accept that good practices have been affected by low response rates.
'Some GPs will lose money from this and some will gain and that is because some are delivering, and some are not.'
As the results came out, GPC chairman Dr Laurence Buckman again called for the survey to be scrapped, or at least returned to a practice-based version. Some practices have lost five-figure sums, based on the views of just 1 per cent of their patients, according to the GPC.
Mr O'Brien says the DoH will look to 'see how (the survey) can become more sophisticated and developed', signalling that it may be tweaked to avoid more controversy when it is sent out quarterly next month.
But the minister insists that overall, the response rate was good and will not go down when the survey is sent out quarterly.
'IPSOS Mori (which conducted the poll) modelled for a 35 per cent response rate, and it was actually 38. It is a myth that patients will stop responding - patients like to be asked about their care.'
So if practices really want to impress their patients with better access, what should they do?
Mr O'Brien has recently been impressed by innovative ways to improve the way patients contact the surgery. Improving the booking system using emails and texts is a 'key area' GPs can improve, he says.
'I think the real incentive here is the professionalism of GPs. 'It's not about money - I believe most GPs want to improve care for their patients.'
His final comments may not go down well with staff from the 1,300 practices that dropped at least 35 QOF points this year.
Meet the new minister for primary care
Name: Mike O'Brien Age: 55
Seat: MP for North Warwickshire since 1992
Career: Worked previously at the Home and Foreign Offices before becoming minister for trade, minister of state for e-commerce, energy and competitiveness and solicitor general. Most recently he was pension reform minister and energy minister.
Current job: The minister for primary care is responsible for GPs as well as NHS financial and performance management, Connecting for Health and choice.