Your article and editorial arising from a talk I gave to an NHS Alliance workshop, (‘GP chairman seeks to end PMS contract’, GP 1 December) contain serious inaccuracies both in their content and their conclusions.
I made it clear both during the presentation and in conversation with your reporter afterwards that I had been asked to speculate where GP contracts might be going in the future and that my suggestions were personal speculations and certainly not my or GPC policy. I never used the term ‘abolish’ in respect of PMS — I am a PMS GP myself. Instead I suggested that some PMS GPs might welcome the protection afforded by a national contract and welcome a nationally negotiated, orderly return. Others would not wish to do so; I was certainly not suggesting any compulsion.
In speculating that we might end up with fewer contractual options I made it clear that these would be similar to, but certainly not the same as, the present GMS and APMS, though they were useful labels to indicate the nationally based nature of the former and the locally based nature of the latter.
In terms of the reform of GMS, I highlighted some of its shortcomings, particularly in respect of new or rapidly growing practices and suggested ways in which the present formula might be developed. One way would be to consider some combination of capitation-based payment together with an allowance, but certainly not a return to the basic practice allowance as you claim in your editorial.
There is no question of ‘throwing out the achievements’ of the new contract and returning ‘to a previous system’. To claim that I was suggesting this is totally to misrepresent my arguments.
Dr Hamish Meldrum
Chairman, the GPC, London
