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GP plans to sue over anticonvulsants

There will be no Saabs or plasma TVs

for GPs if they sign up to

practice-based commissioning ­ Ian Cameron reports

GPs are highly unlikely to repeat fundholding windfalls if they sign up to the Government's practice-based commissioning scheme.

Department of Health guidance released last week said practices could keep half of any savings they made by taking over commissioning, but stated 'savings must not be used for individual profit'.

The stance is aimed at ensuring loopholes which enabled fundholding GPs to pocket NHS cash are closed.

Health minister John Hutton said there was no question of GPs 'going out and buying a Saab and a plasma TV' if they became involved. He insisted GPs would be motivated by improving care for patients and making services more accessible in the community.

Mr Hutton said PCTs had failed to engage GPs in how services were provided and there was 'no alternative' to the new structure.

'The professional executive committee and PCT structure is not really working,' he said.

'We need to be honest about that. In creating PCTs we lost something in the process. But this is the way to reconnect frontline staff with the commissioning process.'

The plans received a mixed response from GPs.

GPC deputy-chair Dr Laurence Buckman said he did not believe GPs would gain financially by joining the scheme and criticised the lack of strict national guidelines.

'You need national guidelines otherwise you get wide variations in what goes on. You then get things happening out of the ordinary that were not intended and may not be best for patients,' he said.

Mr Hutton said he wanted PCTs to implement the policy according to local needs.

PCTs involved in pilot programmes said doctors had not reaped huge rewards but had earned a little more from providing new services.

Ian Tully, chief executive of East Devon PCT, said GPs could provide the same services cheaper than secondary care.

'This is not about siphoning off resource but about controlling that resource,' he said. 'Rather than GPs going out and buying a Porsche we will buy a service from them and that's where they will derive a financial benefit from.'

But some GPs said they needed more of a reason to get involved. Dr Myroslav Para-shchak, a GP in Heywood, Lancashire, said: 'Money is the only incentive there is.'

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