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Independents' Day

Drop this crazy idea of capping top GP earners

Your headline 'Quality pay cap to hit top earners' (News, November 24) is infinitely depressing. It means practices that work hard to

maximise the care of patients with the chronic conditions specified in GMS2 will not receive all of the financial reward they would otherwise be due under the Blue Book agreement, for which the majority of GPs voted.

Instead, money will be diverted to practices that claim a lower prevalence of these conditions. The apparent reason for this is that low-prevalence practices would be 'destabilised'.

This simply beggars belief. All GMS practices will be destabilised by the introduction of the GMS2 contract next April. The reason for GMS2 is that general practice had become destabilised by its lack of appeal. Destabilisation is normal. Without it no progress can ever be made.

Practices that deliver high-quality care to a large number of chronically-ill patients deserve to be properly rewarded. And if practices have a low prevalence of chronic illness then they should be able to find the time to deliver more enhanced services.

I suspect, however, that the idea is to support failing practices at the expense of successful ones, another example of Miller's Law.

If the NHS is ever to deliver high-quality care then it must discard outdated thought patterns that will never allow any NHS body to fail. Without failure there can be no success.

Sadly Miller's Law runs right through the NHS like the letters in Blackpool rock and is as contagious as influenza.

We don't have to catch it. We can be immunised by discussion with our peers and treated where needed by large doses of common-sense. Please, negotiators and confederation alike, drop this crazy idea like the hot potato it is.

Dr Lewis Miller


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