City and East London LMCs representative Dr Deborah Colvin warned that the US system showed that improving health nationally was difficult in a fragmented system.
She warned against a move to local contract-setting: 'An NHS where each practice and PCT could negotiate its own contract would mean we no longer had a national NHS. The national contract safeguards doctors and patients alike.'
GPC chairman Dr Hamish Meldrum backed the call, and said enhanced services created enough scope for regional innovation. He said: 'A national contract is vital.' He pointed out that backing a national deal did not mean GPs were calling for policies GPs were unhappy with, such as Choose and Book, to be implemented in other parts of the UK.
Devolution and the division of the health service was a running theme for the conference. Dr Sheena Milne, from Lothian LMC, even raised the 'west Lothian question' by asking if Scottish GPs could still vote on a motion of no confidence in the secretary of state - conference happily decided they could.
Dr David Grant, Gwent LMC: 'We have a national contract agreed by all four UK governments. Over the last three years of the new GMS contract there have been different approaches in the four countries, cracks have started to appear. To prevent serious rifts developing, none of these four countries should be allowed to alter the DDRB’s remit.'
Read more views on the LMCs conference in our Editors' blog.
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