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At the heart of general practice since 1960

GPs to be rewarded for poaching each others' patients

By Ian Quinn

GPs who expand their practice list sizes and attract more patients are to get extra funding, under Government plans for primary care revealed today.

The document says GPs who help provide increased choice will see the biggest gains from a new ‘fairer' funding system, to be brought in to replace MPIG, which is to be scrapped.

The Department of Health's primary care strategy also reveals plans to salvage the floundering flagship health policy, Practice Based Commissioning, by giving groups of GP practices more responsibility, encouraging a broader range of clinicians to work together by providing new incentives and forcing PCTs to improve resources such as PBC data.

The move to make GPs more like competitive businesses is likely to be one of the most controversial elements of the plans, which have been launched as part of Lord Darzi's wide ranging NHS Review.

Health minister Ben Bradshaw ensured the report would get a fiery reaction when, in an interview on the BBC website, he accused GPs of operating ‘gentlemen's agreements' whereby they promise not to accept other doctors' patients.

The Daily Telegraph also reported this morning that GPs would be asked to take on millions of post-operation checks under the Government plans.

David Colin-Thomé, national clinical director for primary care, said: ' The strategy sets out our vision for a continuously improving service, where essential services are guaranteed and excellence is rewarded.'

GPC chair, Dr Laurence Buckman, said claims that GPs operated gentlemen's agreements where ‘absolute nonsense'. But he added: ‘Nor are we going to compete for patients, that is not the way general practice works.'


Dr Richard Vautrey, GPC deputy chair, added: 'We are not aware of any local agreements between practices to prevent patients from registering. If there have been cases we would like the Department of Health to share these with us as it is not something we would condone.

'For Ben Bradshaw to make such an assertion shows a real lack of understanding of the actual problem. Some practices are genuinely unable to take on new patients because they're bursting at the seams and in many cases when they ask the local Primary Care Trust for money to expand they're told there is none. The Minister has made a habit recently of making sweeping negative statements about GPs, but he is yet to bring the BMA any hard evidence for his assertions.

'We need to move on from this petty name calling and put the focus back on coming up with ways to make sure patients get the top quality care they deserve.'

The Department of Health said key elements of the plans where:

• Providing better rewards for GPs who provide responsive, accessible and high quality

services, and attract more patients, making it easier for patients to choose their

GP practice, and developing a fairer funding system for GP practices

• Working with the Royal College of General Practitioners to develop a voluntary

accreditation system for GP practices, to be rolled out by 2010, and working

with the new Care Quality Commission on a registration process to ensure that

local services meet national minimum requirements for safety and quality

• Launching a an expanded GP patient survey measuring aspects of care that patients

value the most from their GPs and rewards for GPs that become more responsive

• Reviewing QOF indicators, and discussing with the BMA and others how

to refocus QOF more on health promotion, clinical quality and health outcomes

• New opportunities for GPs to have a more prominent role in leading the service

design by reinvigorating practice based commissioning, making sure that PBC

groups are entitled to the necessary information and resources

Ben Bradshaw: talking nonsense says BMA Ben Bradshaw: talking nonsense says BMA

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