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Gold, incentives and meh

GPs back plan for six-month ballot delay

GP negotiators have left the door open for a long delay in the contract ballot following a call from two GPC members to renegotiate the entire deal from scratch.

The move gained extra weight after Dr Julian Neal, chair of this week's special LMC conference, said the central theme of the motions was for more time to sort out the problems with the contract.

GPC members Dr Gillian Braunold and Dr Fay Wilson have proposed what they call a 'third way' as an alternative to a straight Yes or No vote.

They want the Carr-Hill formula replaced or remodelled, the quality framework simplified and an overhaul of pension and IT arrangements.

GP negotiators have pled-ged to consult with the Government on the proposal, which calls for 'a pause while the contract is modified, properly tested and brought back to an LMC conference in six months'.

Dr Braunold and Dr Wilson say they support the

basic principles of the contract but claim the Carr-Hill fiasco and the attempt to resolve

it with the minimum practice income guarantee is just one of many problems (see box).

Dr Braunold, chair of Brent and Harrow LMC and a GP in north London, said GPs were 'feeling pushed into a ballot' and negotiators were using 'sticking plasters' to patch up fundamental flaws.

'Instead of changing the medication, the negotiators are giving medication for the side-effects,' she said.

The proposals will be discussed at a meeting on the eve of the special LMCs conference next week.

GPC negotiator Dr Laurence Buckman described the proposal as 'a very interesting suggestion'. He said: 'We would have to see how it was possible to make it happen if the conference of LMCs thought it was a good idea.'

But he added: 'We are going to see what the Government's opinions are on delays and timing. It would be unwise for anyone to express for or against the proposal without knowing what the Government are saying.'

GPC member Dr Peter Swinyard gave the proposal a cautious welcome, but added: 'I think it's a highly dangerous game. I think if we go down that road the Government might just withdraw.'

Proposals for the 'third way'

Delay contract ballot by at least six months

to allow time to:

 · Amend or replace 'inequitable and destabilising' Carr-Hill formula, with income based on practice capitation not census figures

 · Ditch MPIG ­ a 'quick fix' that would create

two-tier GMS

 · Renegotiate the 'over-complex' quality

framework to ensure it rewards practices with

high morbidity levels

 · Remodel the pensions deal ­ the planned move towards pension based on profit rather than income will act as disincentive to employ good

staff or invest in practice

 · Define IT standards and guarantee protected funding for IT

 · Clarify arrangements for PMS GPs

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