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CAMHS won't see you now

Island is cast away with no GP

GPs who are interested in practice-based commissioning should jump in quickly to take advantage of Government 'bribes'.

GPC deputy-chair Dr Laurence Buckman said GPs needed to be 'canny' if they wanted to make any money from the initiative.

Practices can keep half of any savings they make by taking on commissioning from PCOs but must plough the money back into patient services. Budgets given to GPs to manage are determined by their past spend on referrals.

Dr Buckman said he thought it was 'pretty unlikely' GPs would make money, but they could take advantage of the Government's need to make a success of the scheme.

'You have to get in early as the Government always bribes early waves,' he said.

Fellow GPC member Dr Prit Buttar, a GP in Abingdon, Oxfordshire, predicted ministers would 'throw money' at the first wave to make sure it was attractive to GPs. 'Look back at the early PMS waves. If you are remotely interested remember the lessons of history and if it looks attractive take it,' he said.

Overall, GPs expressed a guarded interest in the scheme, which will start in April 1 next year, but some questioned whether PCOs or practices had sufficient management expertise.

NHS Alliance GMS

contract lead Dr David Jenner, a GP in Collumpton, Devon, said areas with high deprivation or with GP or managerial vacancies could be left behind.

He said: 'In deprived areas practices tend to be smaller and might have less managerial experience so PCTs may need to second staff to help them.'

Dr James Heffer, a GP in Bradford-on-Avon, Wiltshire, said the proposals would not work in 'more average' PCTs. The result would be 'ghettos' where practice commissioning had not reached.

'Where there's no clinical engagement and structures, buildings and institutions are not fit for the purpose ­ it's unbelievable,' Dr Heffer said.

Many GPs said they would still be absorbed in the quality framework and unable to devote time to budgeting.

Devon LMC chair Dr Peter Jolliffe said: 'Quite a lot will be interested if they have the

energy.'

By Ian Cameron

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