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New DESs will have little impact

The directed enhanced services for practice-based commissioning and implementing choice will make little or no differ-ence to GPs' willingness to take part in the controversial schemes.

Fewer than one in five GPs said the £1.90 per patient for practice-based commissioning would make them more likely to take part. The figure compared with 32 per cent who said they were less likely to do so as a result. Many GPs said the money was insufficient to cover the real costs of getting involved, such as hiring extra staff.

Dr Mike Caruana, a GP in Swanage, Dorset said he was 'very disgruntled' with the way practice-based commissioning was being implemented. He said: 'Commissioning used to be optional, but now it's been made compulsory and is being forced upon us. The money is not going to cover the realistic costs of it.'

The £1 per patient enhanced service for choice and booking received a marginally better response. Although just 19 per cent of GPs said it made them more likely to take part, only 18 per cent said it put them off doing so.

Dr David Johnson, a GP in Brecon, was typical of many respondents in feeling that the choice agenda had been 'foisted' on GPs. He said: 'It's illogical. The idea of having a patient choosing is ludicrous when it's us that know which consultants are best and which lists are shortest.

'It won't have any effect on reducing waiting times.'

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