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At the heart of general practice since 1960

GPs urged to take leap of faith

GPs will finally get their chance to vote on the new contract from June 2 after the GPC voted overwhelmingly to take a high-risk gamble on a Yes vote.

The decision came after GP negotiators won some of the concessions demanded by GPs in a frantic final two weeks of wrangling with the Government.

But negotiators admitted they were asking GPs to take a leap of faith because they won't have the crunch details needed to predict their income accurately.

The concessions include the guaranteed use of registered lists as soon as the contract starts in April 2004 and weighting of quality pay using practice disease prevalence

data from April 2005.

The 100/150 point penalty for practices choosing the minimum practice income guarantee has been scrapped.

GP negotiators said they believed they had 'done enough to get a Yes vote'. GPC chair Dr John Chisholm recommended the deal as 'the right way forward for general practice' and the best GP contract since 1966.

Dr Simon Fradd, GPC joint-deputy chair, said: 'I will be voting Yes for it and I will encourage other GPs to vote Yes.'

GPC members voted 44 to one in support of the deal.

But it took an emergency lunchtime phone call from Dr Chisholm to NHS Confederation lead negotiator Mike Farrar to change the mood of last week's GPC meeting where the crucial decision was taken. GPC members had rejected an 'intention' to remove the link between Carr-Hill and quality payments and demanded a 'commitment' instead.

'The mood improved after that,' said one GPC member.

To fund the changes, practices' global sum pay has been cut from £53 per patient to 'between £50 and £51'. A planned £1 per patient rise in the second year has been scrapped. Quality preparation money has also been cut. The average three-partner practice will still receive £9,000 in 2004/5 but only £3,250 in 2005/6 and nothing in the third year.

Funding for London weighting has been cut from £53 million to £35 million.

GPC member Dr Ron Singer, a GP in north London, said the whole process had been 'absolutely ghastly'. He added: 'There is something wrong when we cannot tell GPs exactly what they are likely to be earning before they vote.'

GP negotiators said they expected 78 per cent of practices to start in MPIG.

The deal on offer

 · Ballot papers go out on June 2; vote closes on June 20

 · Registered lists from day one

 · Quality pay weighted by practice disease prevalence

 · Scrapping of 100/150 quality points penalty for MPIG practices

 · Global sum cut from £53 per patient to 'between £50 and £51'

 · New deal on seniority pay

 · Review of Carr-Hill formula in October 2004, with any new factors included from April 2006

 · PMS GPs to get 'limited guidance' in time to vote

 · No Plan B before ballot closes

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