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GP uproar at 'unfair' PCT star ratings

The Government's league table of primary care trust star ratings has been branded 'monumentally unfair' for

penalising GPs in deprived

areas and awarding huge cash bonuses to leafy areas.

As GPs in zero-rated trusts steeled themselves for an onslaught aimed at improving their performance, their colleagues in three-star trusts were welcoming bonuses of up to £500,000.

Experts said the system was divisive and would widen health inequalities and risk

creating two-tier general

practice.

The first-ever PCT star ratings, covering all 304 trusts in England, were released by the Commission for Health

Improvement last week.

Forty-five trusts won three stars and will qualify for bonuses of up to £500,000.

But the 22 zero-rated trusts will be forced to draw up improvement plans for approval by the NHS Modernisation Agency and to have trouble-shooters parachuted in from the National Primary and Care Trust Development Programme to haul up their

performance.

There were widespread claims the ratings system was biased towards rural and leafy areas, which featured heavily among three-star trusts.

In contrast, not a single trust in England's three biggest cities was awarded the top rating.

Dr David Jenner, NHS

Alliance spokesman, said the system failed to allow for the challenges facing GPs in deprived areas.

'We have serious concerns over the validity of the performance indicators,' he said. 'You can't tell if you are rewarding the right people. In areas where there is specific deprivation, resources won't get through to where they are needed.'

John Appleby, chief economist at the King's Fund, said the decision to reward top-rated trusts would worsen health inequalities. 'There are no three-star PCTs in London, Manchester or Birmingham, where there are significant problems with funding. It would seem to compound some of the problems PCTs may have.'

GPs in zero-rated trusts pledged to resist any pressure to carry the can for poor performance.

Dr Brian Balmer, chair of Essex LMCs under which

zero-rated Thurrock PCT falls, said: 'I'm waiting to see who comes down on the PCT first. If this puts more pressure on GPs we will have a lot to say about it.'

CHI acknowledged the ratings were 'far from perfect' and commission chair Dame Deirdre Hine said she was looking at ways the system could be improved so ratings reflected 'the true performance of trusts'.

 · Further details, page 4

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