Making use of cognitive behavioural therapy in a 10-minute consultation
Delays in talks between the Government and GPC are threatening to leave GPs stuck with the discredited Carr-Hill allocation formula for years to come.
GPC negotiators warned this week that hold-ups caused by the ministerial clearout at the Department of Health meant time was running out on agreeing a new formula.
GPs have demanded Carr-Hill be overhauled or scrapped entirely because it fails to properly distribute money according to practices' needs.
A review is taking place this year to implement a new formula from April 2006.
Dr Hamish Meldrum, GPC chair, said talks had already been delayed by a month due to the election and a meeting with new ministers could still be weeks away.
He added that negotiators were 'anxiously' waiting for the Government to first reveal how much it planned to put in the pot for GPs' global sums from 2006 onwards.
Dr Meldrum said: 'Without knowing the funds available it's difficult to put other negotiations into context.
'The longer the uncertainty the less time there is to make decisions and model more radical changes.'
A new formula would need to be rigorously tested to avoid a repeat of the 'Black Wednesday' crisis in March 2003, when 90 per cent of GPs were told they would lose money under the new GMS contract.
Negotiators had to agree an emergency deal to protect GP incomes via the minimum practice income guarantee, otherwise the contract would have been rejected.
GPs warned a rerun of the debacle, caused by a lack of time to test the original Carr-Hill formula, would not be tolerated.
Dr Ron Singer, president of the Medical Practitioners Union and a GP in north London, said: 'If there's another mess-up relating to pushing through changes too quickly that will reflect very badly on the GPC and Government.'
But he added that GPs would be equally angry if the formula remained unchanged.
'GPs are allergic to the words Carr-Hill,' he said.
Changes to the formula demanded by GPs include factors for economies of scale, deprivation and ethnicity. Exist- ing factors are age, sex, market forces, rurality, morbidity and mortality and list turnover.
Dr Hank Beerstecher, a GP in Sittingbourne, Kent, said unless the number of practices on MPIG was reduced, any future changes to the contract would be 'like rearranging the deckchairs on the Titanic'.
Potential changes to Carr-Hill
·Economies of scale factor (removed by ministers at the last minute in 2003)
·Non-English speaking patients factor
·Re-examination of existing gender and age data
By Ian Cameron