LMCs seek cuts to IT, NHS Direct and Darzi centres

GPs' union representatives are set for two days of largely anti-government debate when they meet next month in London for the two-day annual conference of local medical committees.

GPs want the GPC to list services that could be axed to save money
GPs want the GPC to list services that could be axed to save money

Virtually all the 803 individual and composite motions express anger, frustration and bitterness against the policies and practices of the last government - and fear of what is to come.

The GPs are set to ask their union leaders - the GPC - to publish a list of projects and services, many front-line, that could be axed or run down to save money.

These include Darzi centres, NHS Direct, ‘costly IT projects' and private finance initiatives.

In combative mood, they ‘insist' that the government tells patients honestly about front-line cuts, reduces their expectations and makes sure primary care organisations (PCOs) implement cuts equally. They insist that primary care should ‘not be targeted' for cuts.

Scrapping practice boundaries and working in polysystems will take centre stage in a keynote talk from Professor Chris Ham, chief executive of the King's Fund.

GPs will then debate whether scrapping practice boundaries will be ‘deeply flawed', costly, destructive, destabilising and discriminatory.

Many motions express ‘belief' but fail to instruct the GPC. Most are a reaction to the past year in general practice - the failure to implement the DDRB's pay recommendations, pandemic flu mismanagement, ‘bullying' PCOs interfering in PMS contracts.

But there are fresh ideas: that GPs can choose which PCO they contract with, and that all new enhanced services should apply nationally and all PCOs be obliged to offer them.

New ideas for promoting partnerships to ‘prevent wholesale death by salary' include a five-year limit on salaried contracts unless partnership is offered, more cash incentives and a basic practice allowance for partnerships.

In anticipation of GPs taking back responsibility for out-of-hours, they call on the GPC to ‘urgently' come up with a ‘minimum set of criteria, independent of the RCGP'.

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