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Independents' Day

£1m Primecare deal threat to co-ops

GP co-operatives may face a fight for survival after commercial deputising service Primecare won a hotly contested £1 million out-of-hours contract.

The threat to co-ops' future emerged after Herefordshire PCT awarded the county-

wide annual contract to Primecare despite a competitive counter-bid from local

co-op Shropshire Doctors on Call.

All local practices will lose their out-of-hours development money to fund the scheme, prompting fury from some GPs (see left).

GPs who choose to use Primecare will not have to pay for out-of-hours care if they work shifts.

The trust said Primecare had pipped the co-op to the contract because of its national status.

Dr Bruce Herriot, chair of the PCT's out-of-hours steering group and a member of the national out-of-hours advisory group, said: 'The costs were very similar for the two of them.

'But Primecare has the advantage of two large call-

handling centres.

'If we were using one and the IT network went down they could very quickly divert to the other.'

The likely impact of the new contract was another factor, said Dr Herriot, a GP in Cradley. 'Whoever we chose had to have the flexibility after December 2004 to deliver a less GP-led model.'

Shropdoc's medical manager Dr Steve Hugh branded the reasons 'spurious' and warned that less GP leadership in out-of-hours care could mean lower pay and worse working conditions for GPs who did want to work shifts.

Primecare's national medical director Dr Mike Sadler, a former GP, said: 'This contract with Herefordshire provides a potential model for the future for both Primecare and PCTs. We would be very keen to work with other PCTs or even across several trusts.'

Dr Sadler said Primecare hoped to 'occupy a substantial part of the out-of-hours market over the next few years', with a target of 925 more GP clients in 2003, growth of around 10 per cent.

Simon Hairsnape, director of health development at the PCT, defended the decision

to withhold out-of-hours development money from practices that stick with the co-operative.

'Everyone has access to a fully-funded out-of-hours service ­ if GPs want to do something on their own they can, but the PCT can't fund it twice.'

Dr Mark Reynolds, chair of the National Association of GP Co-operatives, said: 'I

am surprised the trust have decided which way they want to go in this climate of uncertainty, but I wish them luck in what I think is Primecare's first foray into wide area rural


'I hope the trust will not regret the decision.'

Dr Andrew Black has accused his PCT of 'financial blackmail' over its new out-of-hours service. Dr Black, a GP in Kingsland, has been told by Herefordshire PCT he must sign up to the new Primecare service or give up his practice's £9,000 out-of-hours development money. Dr Black wants to stay with Shropdoc co-op, despite the financial loss. 'What the trust did was financial blackmail,' he said.

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