The 'new contract' was only finalised in 2004. One must ask oneself why the change in attitude now?
Surely it cannot be the threat of private initiatives reducing GP profits.
The personal relationship between GP and patient is the 'glue' and registering with a GP of one's choice the patient's right.
However, with the new contract, global sum and no after-hours commitment, partnerships have been able to employ salaried GPs to do much of the work while the partners retain the profits.
So, one partner with 10,000-20,000 patients registered can employ salaried GPs and the patient won't see the GP they registered with.
Who then, if practices form federations as the RCGP's 'road map' suggests, will do the after-hours? Not the partners, I predict. It is more likely to be salaried GPs, especially employed for the purpose, and locums.
Has the quality framework really improved patient care? Many areas are not covered and may be neglected if the profit incentive is not there.
I see no disadvantage to patients of private-led practices. Give the patients the choice.
Of course there is no single fit for all, and a small country practice will continue as such. Competition will improve care.
My £435 membership fees have helped produce this document and I will let you know if I think I have got my money's worth once I have digested it.
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