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Enhanced services cash 'has already been spent'

GPs are unlikely to get paid for many enhanced services because the money has already been spent, cash-strapped primary care trusts are warning.

The claims came as Health Minister John Hutton sent a letter to all strategic health authorities ordering them to ensure their PCTs ringfence enough funds to meet the national guaranteed investment in enhanced services promised in the contract.

In a legally binding directive, Mr Hutton set out exactly how much he expected each PCT to spend on the services over the next three years.

But PCTs said they did not realise the money had been included in their three-year cash allocations and it had been allocated elsewhere.

Dr Roger Sage, professional executive committee chair for St Albans and Harpenden PCT and a GP in St Albans, Hertfordshire, said PCTs had already spent the 'vast bulk' of the money on hospital services. 'GPs are supposed to get 30 per cent of our money from enhanced services and goodness me, the money's not there,' he said.

'PCTs are saying "we don't have the money" and the Department of Health is saying "yes you do". But you can't spend the money twice.'

Dr John McKay, professional executive committee chair of Sunderland PCT, said: 'Given the state of PCTs' budgets at the moment there will be major problems. If PCTs are expected to fund enhanced services something else will suffer.'

Dr David Jenner, the NHS Alliance spokesman on the

issue, warned GPs not to rely on any pay for national enhanced services when calculating practice income with the BMA ready reckoner.

He predicted PCTs would find 75 per cent of the promised funding for directed enhanced services but would struggle to find any money for national enhanced services in the first year.

GPC negotiator Dr Andrew Dearden urged GPs to threaten PCTs with the small claims court if they refused to pay for enhanced services.

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