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Crunch battle on registered lists funding

The Government has severely dented GP negotiators' hopes of thrashing out a deal on registered lists in time to convince this week's crunch GPC meeting to go for a ballot.

The row over negotiators' call to slash the quality fund so global sum payments can be based on practices' registered lists is the key hurdle in the make-or-break talks with the NHS Confederation.

Negotiators insist the contract must kick off next April using registered lists rather than census data to calculate practices' global sum allocations. They want the switch funded by cutting the money committed to quality payments.

But confederation lead negotiator Mike Farrar said ministers would not tolerate this: 'We are not prepared to renegotiate the whole contract.'

He said any commitment to use registered lists would have to be funded by cutting the average payment per patient from £53 to £49.85. Practices with many ghost patients would suffer most.

Ministers made clear they are losing patience with the continued wrangling, insisting 'it is now time for a ballot'.

A source close to Health Secretary Alan Milburn said: 'We cannot have a situation where we conduct negotiations and establish a position with GPs' leadership and a deal that is done is unpicked.

'That is not the way we conduct industrial relations. We have put the money in and kept our side of the bargain.'

Dr John Chisholm, GPC chair, said he wanted a written undertaking from Mr Milburn to ditch the use of inaccurate census data ­ one of two key concessions demanded by the GPC.

He added: 'If we did nothing else the money would fall to £49.85 per patient but we are looking at not making that drop. Moving money from quality to the global sum is one way of funding this.'

But Mr Farrar told Pulse: 'Taking money out of quality would change the balance of the contract and open us up to challenges of unfairness. It doesn't incentivise high quality but rewards [GPs] with high lists and low quality.'

He reiterated a warning from Health Minister John Hutton that any tinkering with the distribution of funding between practices would create as many losers as


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