Letters: QOF prevalence pay cut to London GPs is justified

My heart bled when I read of the plight of London GPs whose pay is to be cut as a result of the removal of the square root fiddle factor from the calculation of their QOF payments (GP, 17 April).

You might have mentioned that the money that they were receiving was for work not actually done and was merely a totally unjustified transfer of funds from hard-pressed practices in deprived areas of the country, which presumably also include some parts of London.

Elaine Gill, a London-based medical accountant who is clearly an authority on medical workload in deprived areas, is quoted as saying: 'It's a bit silly to say that London practices have an easier workload than everyone else'. Actually it isn't.

The prevalence factors have revealed quite clearly that these practices do have an easier workload. To suggest that a greater part of a London GP's time is taken up by mental health problems, drug users and people who speak English as a second language is pathetic, ridiculous and not borne out by the facts.

All of these problems are also a major concern in deprived areas throughout the country and, in any case, mental health is part of the QOF and the treatment of drug users is separately funded under the Shared Care initiative.

As for patients who don't have English as a first language: I very often go through an entire surgery without seeing a single patient whose mother tongue is English.

GPC negotiator Dr Chaand Nagpaul's suggestion that money 'liberated' by this process should be reinvested in other practices in London is outrageous.

No it shouldn't. It should be used to pay those practices that have high prevalences and have actually done the work for which they have so far not been paid, whether in London or not.

If London doctors don't like suddenly being treated fairly and on the same basis as everybody else they are free to move elsewhere to practise. However, the fact that there is a greater excess of trained GPs in London than in the rest of the country would suggest that nobody is going to get killed in the rush.

  • Dr Alan Keith, Rotherham, South Yorkshire.

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