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Contract 'will take years to even out inequalities'

General practice is split into haves and have-nots and the new contract will take years to close the gap, warns the public spending watchdog.

The Audit Commission found GPs in the same primary care organisation received up to 30 times as much cash for each patient as nearby practices.

The findings have led to renewed calls from GPs for the Carr-Hill formula to be amended or scrapped.

GPs said the fact most practices needed an MPIG correction factor to preserve their Red Book earnings meant the formula had failed to redistribute resources. GP negotiators admitted relying on MPIG meant change would be slower, but blamed ministers for failing to pump more money into global sums.

The Audit Commission report, 'Transforming Primary Care', looked at 200 practices in nine PCTs. It found the median expenditure per registered patient varied from £51 to £106 between trusts. But in one trust, one practice received £10 per patient whereas another spent more than £300.

The commission concluded: 'Resources and services vary widely between GPs, with wide variation in value for money. PCTs were often unaware of these differences.'

Andy McKeon, managing director of health at the Audit Commission, told Pulse it would 'take some time' for the contract to make a difference.

'It's clear from the size of the inequities it could not be done over the next two or three years,' he said.

Dr Kailash Chand, secretary of West Pennine LMC, called on GP negotiators to create a new allocation formula to correct disparities. 'What the Carr-Hill formula has done is totally demoralise the GP workforce. Scrap Carr-Hill and come up with another.'

Dr Ambady Gopinathan, co-chair of Newham LMC in east London, said: 'Inner-city GPs will have to work harder.'

GPC joint-deputy chair Dr Hamish Meldrum said the contract 'would start to correct' disparities. 'When you are starting off from a bad position unless you are going to put an enormous amount of money in it's going to take time.'

By Nerys Hairon

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