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Gold, incentives and meh

An own goal with PBC

The Department of Health is probably rivalled only by the Football Association in its ability to make complete failure sound like progress. But its attempts to spin the fact two GPs in five have 'adopted' practice-based commissioning as the NHS 'surging ahead' are as abject as England's penalty taking.

Its target was for every GP to have agreed a local plan with their PCT and received the first 95p per patient DES payment by the end of June. Yet the majority have not. And the reason is that PBC is moving further and further away from its original intention. PCTs are only bothered about one thing at the moment – how to save money. And PBC's function is simply to do that.

The result is that trusts are dictating terms, setting unreasonable and unreachable conditions and suffocating the scheme to death.

In addition, those GPs who are involved know that, whatever the department says to the contrary, PCTs will do everything in their power to retain the 70 per cent of savings practices are meant to keep.

For as long as these doubts remain, PBC is doomed to mirror England's World Cup campaign. Full of initial promise, hobbled before it started, then limping along until the predictable lame failure.

Pay up, Mr Blair

'It's very simple,' said the PM. GPs are not overpaid. Indeed, it's good that they're earning more. So it would hardly be fair to deny them their rightful and well-earned pay rise next year. Would it, Mr Blair?

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