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Department of Health pushes ‘enormous’ cuts to GP contract

Exclusive GPs could be faced with swingeing cuts to practice income next year after it emerged the Department of Health had approached negotiators with ‘totally unacceptable' proposals for the GP contract that were rejected out of hand by GPC chair Dr Laurence Buckman.

A senior GPC member told Pulse he understood there were ‘enormous' cuts planned for next year, as ministers try to squeeze 4% efficiency savings from GPs to match the savings sought in secondary care.

Pulse understands officials approached Dr Buckman directly to sound him out on a possible deal prior to formal negotiations, but he rejected the approach and refused to negotiate under the terms suggested. 

A BMA source said the GPC had not formally discussed the proposals, believed to include moving some enhanced service funding into the core contract, but had been briefed on them.

Dr Peter Fellows, president-elect of the BMA's Gloucestershire Division and a GPC member, revealed the efficiencies being pushed by the DH in a letter to Pulse, in which he launched a wide-ranging attack on the Government's plans for the NHS. Dr Fellows, a GP in Lydney, Gloucestershire, warned if cuts to funding continued, ‘practices will begin to go bankrupt'.

‘The cuts – so-called efficiency savings – that are now on the table for practice funding next year are enormous. I'm not able to elucidate – there is too much secrecy from the GPC,' he said.

Pulse's BMA source said Dr Buckman had been ‘sounded out' by officials on a series of proposals to achieve 4% efficiency savings in the GP contract, which he had rejected.

The source said some GPC members had reacted angrily, describing the proposals as ‘totally unacceptable' and claiming ‘the Government has gone mad'. Others played the development down, describing it as ‘kiteflying' and a ‘nuclear option' the GPC would never agree to.

Dr David Jenner, a GP in Cullompton, Devon, and the NHS Alliance's GMS and PMS contract lead, said he understood ministers were seeking efficiency savings ‘to equal those being sought in secondary care': ‘I would expect it means adjusting QOF thresholds and putting more of the NICE markers in so people are seen to be doing more for the same.'

Some GPC members have expressed concerns that the negotiating process is too secretive, with GPC members barred from updating LMCs on latest developments. One GPC member, speaking on condition of anonymity, said: ‘Negotiators are in a difficult position, but I don't like the secrecy. When we go to GPC, virtually every agenda item now has a box around it which means we are not at liberty to discuss it with anyone outside, including our LMCs.'

Another wrote in an email seen by Pulse that briefings to LMCs bore little relation to the content of GPC meetings.

Dr Buckman was out of the country as Pulse went to press, and GPC deputy chair Dr Richard Vautrey refused to discuss contract negotiations.

But he said: ‘I would refute the fact that LMCs are kept completely in the dark. Laurence keeps LMCs informed very well on a week-by-week basis.'

‘But we have to be very careful about releasing information to large numbers of people because that information becomes more public and that's not helpful.'

A Department of Health spokesperson said: ‘Any changes that might be needed to the General Medical Services contract are being negotiated in the usual way, between the BMA's GPs' committee and NHS Employers on behalf of the Department.'

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