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Ministers want GP market

A drive to make GPs compete for their livelihoods against commercial providers is behind ministers' controversial decision to end the ban on sale of goodwill.

A senior Department of Health official has told Pulse the Government changed the rules to give private providers a 'level playing field' to bid against GPs for in-hours services. Ministers see the move as part of their high-profile drive to increase patient choice.

As the GPC and RCGP held urgent talks to assess the full implications of the change, fears were growing of a real threat to GPs' pay prospects.

GPC negotiator Dr Laurence Buckman said it was inevitable GPs would face greater competition for enhanced services contracts which are supposed to make up 20 per cent of practice income under the new contract. 'This must make many GPs very nervous,' he said.

The senior department official said ministers wanted to encourage commercial out-of-hours providers to expand into daytime general practice. 'It would be up to GPs to challenge it,' he said.

He said ministers had now shelved plans to reopen negotiations with the GPC on dual registration and saw the goodwill move as a less complex way to increase patient choice.

The provocative comments came as it emerged the BMA hired top QCs in a desperate bid to prevent the new regulation going through Parliament.

But the rearguard action was thwarted by the fact there were just 48 hours between the regulations being laid and Parliament going into recess. GP negotiators have now given up hope of challenging the new rule for at least two years.

GP negotiator Dr Peter Holden admitted the GPC had been caught on the hop and said BMA officials were still grappling with the full implications: 'We've had so little time to get our heads round it.'

RCGP chair Professor David Haslam ­ who was locked in crisis talks with GPC negotiators last week ­ said he was particularly worried for patients with more than one chronic disease. 'If PCTs start commissioning diabetes care separately from general practice, it will be damaging and risky for patients,' he said.

PCTs gave a lukewarm response to the idea of commissioning in-hours services from private providers.

 · GPs 'won't cash in on

profits', page 7; Comment, page 20

By Ian Cameron

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