LMCs want prevalence square rooting to end

More than half of GPs want to abolish the square root formula applied to prevalence in the quality framework. In a GP survey of LMC representatives, 57 per cent opposed it and variously labelled it as 'unfair', 'iniquitous' and 'totally rubbish'.

A further 10 per cent, questioned at the annual LMCs conference in London this month, said that they wanted the formula changed but not abolished.

Dr David Reede, of Liverpool LMC, said: 'It penalises high prevalence rather than rewarding it.' While Dr Sarah Morgan, of Bro Taf LMC, said that this was especially important in Wales where prevalence is significantly higher than the rest of the UK.

GPC negotiator Dr Andrew Dearden told the conference that square rooting 'should be replaced by a system that ensures payments more accurately reflect the workload involved in achieving targets'. This was backed by 67 per cent of delegates.

The majority of GPs do not think the government should limit the number of alternative primary care providers and are happy for private firms to hold commissioning budgets.

A number of GPs said that if the DoH wanted a truly level playing field to compete in primary care, they would have to accept any comparable alternatives and offer them the same commissioning power.

GPC member Dr Peter Fellows said that 'all providers must have to pass the same tests'.

However, in both cases there was far from unanimity with 45 per cent of respondents wanting a cap on the number of alternative providers and 30 per cent wanting to keep commissioning budgets away from private firms.

Of those who wanted a cap on alternative providers, about a third said that only GPs should be providing NHS services while many, both for and against a cap, said that it should be dependent on need and local circumstance.

Asked about practice-based commissioning, several respondents told GP that private firms should not be able to profit from or direct public NHS money. Dr Tanya Johnston, Durham LMC, said it was simply too soon to know if it was safe to give commissioning budgets to private firms.

Respondents also showed some support for health secretary Patricia Hewitt with almost two thirds rejecting calls for her resignation. Dr Phil White, of North Wales LMC, said:'It doesn't matter who you have got in charge, the policies will not change.'

However, only one in five would back her assertion that it had been the 'best year ever for the NHS', with the vast majority citing funding deficits and difficulty with new policies as being the prohibitive factors.

SURVEY RESULTS

- 57 per cent want to end square rooting of prevalence.

- 45 per cent would cap the number of alternative providers.

- 30 per cent would prevent private firms holding commissioning budgets.

- 61 per cent back Patricia Hewitt as health secretary but only 19 per cent agree it has been the 'best year ever for the NHS'.

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