GP income under scrutiny in review of new contract
By Ian Cameron
Ministers have launched a three-pronged assault on GPs' incomes with a wholesale review of whether primary care is providing value for money.
GP pensions, the minimum practice income guarantee and how to squeeze more from the QOF will all be on the agenda.
The review will draw together investigations into the GMS capitation formula, the QOF and a financial analysis already under way on PMS.
It is driven by continued concern that the new GMS has not fairly redistributed income – with the MPIG seen as a 'barrier to change' that has blocked moves to improve patient access.
GPs warned the review, expected to report by the end of October, would be used to clear the way for further reforms in procurement and wider use of the private sector.
The Department of Health admitted it was consulting strategic health authorities, primary care trusts, managers, NHS employers and other representative bodies – but said it should not be interpreted as meaning another round of organisational change.
The review will seek to establish 'the effectiveness of primary care medical services' contracting arrangements in the delivery of services to patients,' a spokesperson said.
Dr David Jenner, new GMS contract lead at the NHS Alliance, said he had been interviewed for the review: 'There seemed a real focus on the possibilities of opening primary care up to more competition,' he said.
Dr James Kingsland, chair of the National Association of
Primary Care, said his review interview focused on returning to core principles and 'how to get to the next stage'. He said: 'This is asking whether new GMS is delivering what it is meant to.'
Dr Mark Hunt, a former strategy director at the department, said GPC and Government negotiators would be faced with 'horse-trading' over key issues such as pensions.
He said: 'MPIG stopped the scale of change ministers wanted and protected people who were not very good. The primary care contracting directorate is full of zealous individuals who will push very hard.'
Dr Ron Singer, president of the Medical Practitioners Union, said the review smacked of further privatisation.
Dr Laurence Buckman, GPC deputy chair, said there would be no negotiation: 'MPIG in perpetuity means just that. There's nothing to trade.'