A small victory amid the illogic

Wasn't the White Paper an anticlimax? Other than formalising the entry of large private healthcare providers, spending money unnecessarily on 'health trainers' and a quiet about-turn on community hospitals, there is little new in it.

As usual, it's a political statement with all the selective statistics and spin that this implies: 'MPIG was introduced to ensure that practices did not face a fall in income. This reduction has not happened - indeed, most practice incomes have risen substantially'. This must surely win the prize for the most logically disjointed statement in the entire document.

There are some curious statistics, too. There's a map of 'Under-doctored areas across England' with the explanatory note: 'A PCT is under-doctored if its number of (wholetime) equivalent GPs is less than the national average'.

So by definition, half of the country is under-doctored. Why was this put in? Is it to suggest that after nine years of New Labour saving the NHS, half the country is still in crisis? Or is it to convince us that we are all so badly served by GPs that private US corporations simply have to be introduced?

Nevertheless, there are a few interesting new ideas. The government has at last realised they must ensure that PCT funding is equitable across the country. The concept of an expanding practice allowance is sensible, but carries the threat that you won't get it if you don't open in the evenings and at weekends.

And practices may well enter a catch-22 situation in which they can't expand because they have no room, but can't get finance to build until they prove they are an expanding practice.

It is good news that there will be a shift of resources to the community, and especially to community hospitals. My only concern is whether we have the workforce and space available to carry out all these extra functions.

Finally, there's one wonderful, almost hidden, comment: 'Research also shows that where a practitioner has an ongoing professional relationship with a particular patient, they tend to be more committed to the patient as a person. This is one of the reasons why small practices are popular and will remain an essential part of general practice.'

I don't know about you, but I'd call that a victory.

- Dr Lancelot is a GP from Lancashire.

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