GPs on PMS contracts could lose more than 45 per cent of their profits if PCT proposals to reduce income per patient go ahead.
Several PCTs are considering using reviews of PMS contracts to cut practice incomes. Laurence Slavin, a partner with GP finance specialists Ramsay Brown, says that this could cut some GPs' profits from £110,000 to £60,000, or by 45.5 per cent.
He warned that such cuts would drive doctors out of general practice.
'I don't think that GPs are so worried about their patients that they're going to work for less than they should be,' he said.
Haringey PCT, for example, decided in September 2007 that it would use the review to close the income gap between GMS and PMS practices, and 'move towards a more even distribution of pound-per-patient ratios'.
It proposed a target of £81.07, which is the current average for all the area's practices.
At present the area's PMS practices receive an average of £91.93 per patient, with some receiving as much as £145.
Kensington and Chelsea PCT also aims to reduce payments to PMS practices not meeting targets. It said in October 2006 that 'ideally the PCT would be looking to reduce their per patient cost to approximately £90'.
These costs averaged out at £106, compared with only £70 for GMS contracts.
GP understands that other areas have also considered substantial cuts to per patient funding.
Dr Peter Holden, a GPC negotiator, said that because PCTs were in a strong negotiating position, 'every single one's going to try it on'.
He advised practices to work with their LMC and neighbours to strengthen their hand in negotiations. He added that they should make lists of services that the higher investment level had paid for, so as to help publicize the negative effect of cuts.
Dr Holden said that such tactics had had some success in Suffolk. PMS practices in the county have lost their £1 million local enhanced service payments, so are in effect being asked to do the same work for less money.
'But the draconian measures the PCT had considered haven't happened,' he said. 'Practices have got something they can live with.'
Cuts in Northumberland were recently capped at 3 per cent (18 February 2008).
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