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Gold, incentives and meh

GPs demand list of core services

GPs have demanded GPC negotiators draw up an 'unequivocal list' of essential services in a bid to end growing exploitation of practices by primary care organisations.

The order at last week's annual LMCs conference came after a highly charged debate during which GPs denounced the lack of enhanced services funding and mounting pressure on practices to take on unpaid work.

GPs ignored warnings by negotiators that drawing up a list of core work was 'a dangerous road' to go down, instead arguing it would give practices 'the guts to say no' to PCOs.

Dr Nev Bradley, of Wirral LMC, told the negotiators to 'stop talking and start to lead'.

He said: 'That leadership involves clear guidance about what we do, do not do, and what we might do if we're paid. We are a profession that has lost the guts to say no and mean it. This is about doc-tors' rights to end exploitation.'

Amid heckling from some GPs, GPC joint-deputy chair Dr Hamish Meldrum said it was more realistic for negotiators to advise GPs on work they should not do without extra pay. Attempting to list all essential services was dangerous as there were grey areas that could 'lead to things getting petty', he added.

But his argument fell on deaf ears as GPs overwhelmingly supported a motion calling for the list.

GPs also demanded statutory measures giving LMCs the power to monitor PCO spending and called on the GPC to embark on the

mammoth task of formally reviewing and commenting on every PCO's enhanced service proposals.

Earlier, GPC chair Dr John Chisholm delivered a stinging attack on PCOs for 'timid short-termism' in his opening speech to the conference.

Dr Chisholm accused managers of seeing the enhanced service spending floor 'more as a ceiling' and condemned 'grossly inappropriate rebadging of pre-existing services'.

He said: 'One of the greatest causes of anger and disillusionment has been the failure of many PCOs to commission sufficient practice-based enhanced services.'

In a further motion, GPs deplored the fact that enhanced service funding floors were inadequate even for directed and national enhanced services specifications 'quite apart from local enhanced service programmes'.

By Nerys Hairon

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