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Gold, incentives and meh

Most lists open in PCTs told to bring in private firms

Ministers are forcing private providers into areas where GPs are already providing good access for patients, a Pulse investigation reveals.

The Government last week told 30 'underdoctored' PCTs they would be included in a national scheme to bring in alternative providers, including private firms, if they did not already have a plan to do so.

But inquiries by Pulse at 23 of the PCTs have discovered that 13 have no practices with closed lists. Similarly, 13 out of 20 with figures had no practices operating an open, but full policy.

In only one of the trusts, Hartlepool PCT, was the number of practices with restrictions on registration into double figures. It had 16 open but full practices.

North Manchester and South Tyneside PCTs had the highest number of practices with closed lists, with six each.

When the procurement policy was announced GPs criticised the Department of Health's use of such a 'blunt' measurement of GPs per 100,000 patients for picking out PCTs.

GPs said the apparent lack of problems with access in the PCTs chosen backed their complaints that there was no evidence for the policy.

Dr Laurence Buckman, GPC deputy chair, said: 'There is, as ever, a gap between true reality and what politicians think is reality. Even private companies will be put off investing in PCTs if the evidence base is so unconvincing.'

Chris Locke, secretary of Nottinghamshire LMCs, which covers two of the PCTs targeted, said the Government had done a U-turn on encouraging skill-mix in practices.

He said: 'We were encouraged to do it under the new contract, but this seems to count for nothing now they have reverted to using such crude statistics. What happened to nurse-led practices?'

North Stoke was one of the PCTs with no closed or open but full lists.

Dr Paul Golik, secretary of North Staffordshire LMC, said the results raised serious questions over the policy of bringing in alternative providers: 'What patients need are committed, independent practitioners who have a proven track record.'

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