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GPs in Northern Ireland are warning the province is becoming a primary care 'backwater'.

Failures in implementing the new contract and the Department of Health, Social Services and Public Safety's refusal to roll out initiatives such as practice-based commissioning mean practices are lagging behind the rest of the UK.

GPs spoke out after the GPC's annual report, released this week, said implementing the contract in Northern Ireland had been 'particularly problematic'.

Most practices in the province are in dispute with local health boards because they have been denied thousands of pounds worth of staff funding.

Further problems have arisen over implementing QMAS quality pay software, payments for hitting access targets and violent patients schemes.

The department last week admitted to a £300,000 shortfall in appraisal funding and agreed to pay GP £300 each.

But GPs questioned whe-ther the decision was a cynical move to try to get GPs to back down on more expensive disputes.

Dr Brian Dunn, GPC Northern Ireland chair, accused the department of ignoring clear statements in the contract. 'They agreed with us over appraisal but there's no shift over staff funding,' he said. 'On superannuation we can't understand why they don't pay it.'

He added: 'On practice-based commissioning I was told there are no plans to introduce it. We don't want to become a backwater again. We almost caught up [with the rest of the UK] but we are drifting back again.'

Dr Eugene Deeny, deputy-chair of GPC NI and a GP in Enniskillen, added: 'Giving way on appraisal we think is the department saying ''we can't give way on baseline staff''.'

Dr Brian Patterson, chair of Northern LMC, said GPs were angry at the department's 'cavalier' attitude over violent patient services. No directed enhanced services for violent patients have yet been implemented in the province.

'They are not optional,' he said.

Dr Patterson added: 'The risk is that patients don't get the benefits they should be getting from the contract. They should get the same treatment no matter where they live.'

By Ian Cameron

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