Practices £36,000 worse off under revised DoH deal

The average practice could be £36,000 worse off under DoH plans to impose a revised contract in April 2008, according to the GPC.

The revised DoH deal is worse than the package rejected by the GPC last week.

Under the revised deal, an extra £25 million would be lost from the quality framework, the £80 million available to practices for undertaking patient surveys would stop and the £158 million spent on directed enhanced services for access and choice and booking would be available instead to PCTs to incentivise extended hours.

The current quality framework thresholds would be uprated.

Under both the revised and original DoH deal 58.5 quality points (worth £40 million) would be removed from the framework.

Dr Laurence Buckman, chairman of the GPC, said: ‘The government seems hell bent on tearing up a quality-based contract designed to improve the health of patients and save lives less than four years after Gordon Brown approved it as chancellor.

‘These cuts will destabilise general practice and make it difficult for practices to maintain quality. An average practice with 6,000 patients could stand to lose £36,000 in resources. The government is showing a careless disregard for patients with diabetes, chronic lung disease, heart disease and those at risk of strokes – quality markers to improve the care of all these patient groups are being removed by the government to finance longer hours for commuters. GPs will do their best to continue to provide good quality care but Gordon Brown’s political objective will inevitably affect the chronically ill.

‘GPs were prepared to extend their hours and the BMA came up with a workable proposal. Imposing this alternative contract change on GPs sends a very negative message to all NHS staff about how little the prime minister values them. GPs have hit 95 per cent of the government’s targets through the quality framework and their patient satisfaction record is high according to the government’s own survey.

‘The BMA will poll GPs to seek their views and will continue with talks during the next 13 weeks to try to achieve a better outcome not just for our members but for the future of the NHS and for patients. The government plans will destabilise and harm GP services for patients.’

The government has written to the BMA to consult on its revised deal if the BMA is not able to agree the negotiated offer after its poll.

Health minister Ben Bradshaw said: ‘The proposal we put to the BMA involves an average of an extra three hours opening per week in return for a more effective use of resources within the current contract and a 1.5 per cent new investment in primary care – amounting to just over an extra £100 million. This would be a major boost, provide greater convenience for patients and be a good deal for GPs.

‘It is disappointing that the GPC has not been able to agree to this, but we very much hope GPs themselves will back a proposal.

‘If they do not, we will need to have alternative arrangements in place for next April.

‘That’s why we have, in parallel with the BMA’s plan to poll its members, begun consultation with the BMA on an alternative set of proposals. These would enable local PCTs to extend opening hours and improve access, based on the views of local patients.

‘The proposals would maintain current levels of investment in GP practices, but would enable the NHS locally to make better use of around £300 million of resources previously used for incentive schemes, out-of-date indicators and local patient surveys.’

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