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Gold, incentives and meh

LMC conference knives out for new contract

The new contract tops the conference agenda but GPs are warned not to overlook other issues – Joe Lepper and Nerys Hairon report

The annual conference of LMCs gives GPs their first big chance to air their views about the new GMS contract – and they have not wasted the opportunity.

Major chunks of both days of the conference this week are given over to debates on essential, additional and enhanced services; sale of goodwill; global sums and MPIG, and the quality and outcomes framework.

Other issues such as IT and premises funding, new out-of-hours arrangements and seniority pay are also prominent.

One thing that is clear from the agenda is that no one involved in the process of negotiating and implementing the deal will be spared criticism.

The Department of Health is accused of incompetence and deliberately misinterpreting the deal the GPC and NHS Confederation negotiated.

GPC negotiators come under attack for their handling of the negotiations and for failing to communicate properly with the rest of the profession.

Most damningly of all, they are also accused of being outwitted by the confederation and the department.

GPs will also launch a withering attack on primary care organisations over their implementation of the deal.

Chief among the criticisms is that PCOs are ignoring national enhanced services and trying to strike cheaper, local deals, causing a 'postcode lottery' to develop.

North Essex, East Sussex and Leeds LMCs are three of 20 LMCs to propose motions on enhanced services.

East Sussex argues that 'funding for enhanced services should not be dependent on the financial health of PCTs'.

Leeds condemns the 'postcode lottery' that is developing. Medical secretary of the LMC Dr Richard Vautrey says GPs' fear is that patients with the same condition will have access to different levels of care or be treated differently.

Both of North Essex LMC motions stress there should be a consistent, national approach to enhanced services rather than a variety of local deals.

Essex LMCs secretary Dr Brian Balmer says: 'We think the PCTs on instruction from the department are trying to convert national enhanced services into a local agreement which means we miss out.'

Dr Balmer adds that while GPs have genuine gripes about the contract they have to strike a balance between 'not whinging too much' and ensuring PCOs know the

profession 'can't be messed around'.

Gloucestershire LMC chair Dr Christine Haseler says a central theme in all debates should be to improve the flow of information to GPs so they can take local action if they need to.

She says: 'The key is better communications and clarity to ensure we have as much information as possible, particularly about resources.'

LMC conference chair Dr John Canning says it is unlikely that firm policies relating to contract implementation will be set by the conference because the deal is so early into its life.

He says: 'It's only three months into it and most things won't have had time to settle down, so making definitive policy will be difficult.'

He adds though that the conference can have a big impact on non-contract issues.

Dr Kailash Chand, medical secretary at West Pennine LMC, echoes the view that GPs should not lose sight of other problems.

He says many issues, such as spiralling locum fees and controversial changes to the NHS complaints procedure, have 'fallen off the agenda' and need to be addressed.

The Government's £6 billion national NHS IT programme is the subject of a number of debates, notably plans for a national electronic patient record and the importance of GPs keeping choice over their computer systems.

Somerset LMC medical secretary Dr Harry Yoxall says IT funding could soon overtake the new contract as the key priority for GPs.

He adds: 'The new contract has dominated our lives over the last year and now it's time to address other areas.'

Judging by the conference agenda, the contract is set to dominate for a while yet. But GPs are well aware of the other challenges and preparing to confront them head on.

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