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GPs may get more rights to charge for private care

GPs may get similar rights as consultants to charge NHS patients for private work under the new contract.

The GPC has revealed that paragraph 38 of GPs' terms of service ­ a clause barring GPs from charging their patients for most services ­ is likely to be relaxed.

But some GPs have warned the move to increase charging rights could lead to a two-tier service.

Dr Prit Buttar, a private practice enthusiast and GP in Abingdon, Oxfordshire, said GPs should be able to charge if a patient requested treatment outside normal working hours.

'It has to be a case of the state buying your time, say between 8am to 6pm, and what you decide to do outside that is between you and your

patients,' he said.

'Having a routine diabetes check is part of essential care but if a patient chooses to have it at the weekend or evening, it is a lifestyle decision.'

Dr Roger Chapman, chair of the GPC's representation sub-committee, said he wanted paragraph 38 amended so he could charge for more administration ­ such as referral letters to private consultants.

GPC negotiator Dr Peter Holden said both sides in the negotiations recognised GPs should be able to charge for certain services.

But he added that the deal had not been signed off because one minister had yet to be convinced that GPs would not 'seek wholesale gain' by working privately while using the NHS as a safety-net

In the past the GPC has suggested 'essential care' be free with GPs allowed to make private arrangements with patients over 'lifestyle' care.

GPC member Dr Ron Singer, president of the Medical Practitioners Union, said the shift was 'a major departure from NHS principles'.

He added: 'My problem is with the mix of NHS and private. This has not been widely talked about. I'm very concerned why it's being kept so secret.'

NHS Alliance chair Dr Mike Dixon said it would be difficult 'to defend private care provided by the same doctors in the same premises as GMS'.

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What services would you charge patients for?

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