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At the heart of general practice since 1960

GPs can ditch Carr-Hill as GPC tries to avert No vote

GPs would be able to ditch the Carr-Hill formula and get a guaranteed rise in their income under last-minute proposals to rescue the contract from a certain No vote.

The plans, which were still being negotiated as Pulse went to press, would mean GPs could base their practice's global sum for 2004 on next year's earnings, plus an uplift for inflation. IT and premises money, plus quality payments and enhanced services fees, would make up the promised pay rise.

Under the plan hammered out by the GPC, the NHS Confederation and the Department of Health last week, GPs who gained under the Carr-Hill formula would have the option of sticking with it.

But once practices moved to the Carr-Hill system they would not be able to switch back.

GPC negotiator Dr Peter Holden said practices could choose the option that maximised their income. 'You can do two calculations ­ the inflated sum and the weighted formula ­ and take the better of the two,' he said.

'You should see quite a big pay rise. You can only go up. You won't get less than you are getting now.'

The GPC has already pledged a 12 per cent pay rise next year as a result of quality framework preparation pay, an uplift on fees and allowances and seniority pay.

Under the alternative deal, global sum payments for 2004/5 would include this increase and add between 3.2 per cent and 11 per cent for inflation. The GPC said it wanted the inflation figure to cover staff costs, including nurse pay rises.

Negotiators said they still wanted all GPs to move to weighted capitation based on the Carr-Hill formula in future, but admitted it could be years before a practice would find it beneficial to switch.

'It may take five to 10 years for the tide to reach your boat and lift it off,' Dr Holden said. 'We've got a deal but once you switch make sure there's lot of water under the keel.'

GPC joint-deputy chair Dr Hamish Meldrum said the original transitional protection scheme would not have coped with the number of losers.

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