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GPs go forth

GPs face cuts despite underspend

GPs are facing major cutbacks in prescribing budgets and enhanced services payments, despite a £500m NHS underspend.

In its financial report for the final quarter of last year, the Department of Health confirmed the NHS had turned around a deficit of £547m into a net surplus of £510m.

But primary care trusts are now contributing a bigger share of the deficits, the report states. It identifies more than £700m that could be further squeezed from PCTs in 'productivity' savings, on top of the £650m made from savings to the GP contract, as reported in Pulse last week.

GPC chair, Dr Hamish Meldrum, said: 'I'm highly critical of the methods the Government used to achieve this so-called surplus. These have affected patient care with delayed referrals, longer waits for outpatient appointments, ward closures and job losses. There has been a lack of openness about the impact on patient care.'

Dr Meldrum also emphasised that a quarter of trusts were still in deficit.

The report identifies that PCTs are now responsible for 69% of the gross NHS deficit, up from 47% last year.

But overspending trusts, many of whom have seen turnaround teams take over their financial management, have largely improved.

The combined deficit of £326m in 2005/6 has been transformed into a surplus of £348m this year. In 49 out of 55 overspending trusts the situation has improved, but six have deteriorated. The deficits are most heavily concentrated in the east of England.

The report highlights a wide variety in the size of deficits, with lowest performers Hillingdon and Cambridgeshire posting debts of £52m.

In Cambridgeshire, GPs are threatening to pull out of practice-based commissioning after the PCT proposed severe cuts to enhanced services payments and is refusing to negotiate on future PMS contracts.

This is after more than £3.5m was cut from prescribing in the last year with similar savings forecast for the coming year. But the PCT's turnaround report says £900,000 worth of savings still have to be found.

Kensington and Chelsea PCT was identified by the Department of Health as a model of good practice for making £10m savings and turning a debt of £21.7m into a surplus of almost £5m. But a local GP and former PCT insider said this had been achieved by 'selling off the family silver', with assets sold and services such as nursing cut and maintained at 'a level I would not want to see continue'.

Health secretary Patricia Hewitt defended the cutbacks, saying: 'If we hadn't taken decisive action to deal with overspending, the NHS deficit would have doubled again this year. Instead the NHS has a fairer financial system than ever before.'

savings or cutssavings or cuts savings or cuts?

* PCTs are now responsible for 69% of the gross NHS deficit
* £700m identified to be further squeezed from PCTs on top of the £650m savings from GP contract
* Kensington and Chelsea PCT hailed as 'model' after £10m cutbacks

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