This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

The waiting game

LMCs stepping up plans for GPs to do more private work by end of this year

Exclusive GPs leaders in England are pushing ahead with plans to develop new structures that will enable GPs to carry out more private work in a bid to increase GP funding, Pulse has learnt. 

The chair of Oxfordshire LMC told Pulse that they have been in discussions with LMCs across England about implementing new structures by the end of the year that will allow GPs to charge fees for carrying out non-contractual work.

Current rules prevent GPs from charging their own patients for care, but Oxfordshire LMC chair Dr Prit Buttar said they have developed models using third-party companies that would ’allow practices to take on what they want’.

The LMC said last year it was developing a ‘Plan B’ to take GPs out of the NHS, following the lead of Northern Ireland, where the GPC is set to vote on collecting practice resignations later this month.

It was, in part, a response to the UK GPC abandoning plans to ballot practices on mass resignation from the NHS, after receiving reassurances from NHS England that it was willing to consider the GPC’s proposals to alleviate pressures on GPs.

Dr Buttar told Pulse that the plans for GPs to provide more private services at the expense of NHS work have moved forward, and he expected to have a model for alternative working in place by the end of 2017. 

He said: ‘We have to look at alternative ways of increasing funding and look at models which will allow practices to operate within the rules. They will offer practice services, for example if someone wants a minor operation but can only do this in an evening then they can do this by charging a small fee.

’It will allow GPs to value their own time more and puts pressure on the Government. The Government is a monopoly customer, they can dictate how much they are willing to pay.’

Under the plans, GPs will be able to provide private services to their own patients by working through a third party company, which would take payment from patients and then pay GPs for their time.

Dr Buttar said: ‘We want to put in place something which is robust which can be rolled out across the country and will allow GPs to specify which services they want to provide.’

He added: ’We are in preliminary discussions with other LMCs to come up with terms of reference. We want to get something in operation by the end of the year.’

GP leaders in other parts of the country agreed that the current situation was untenable but that they would wait to see if promised improvements to the GP contract would come into force before contemplating handing back contracts.

Wallsall LMC medical secretary and GPC member Dr Uzma Ahmad said that while some conditions had improved for GPs, it remained to be seen whether promises made by NHS England in the GP Forward View would be met.

Dr Ahmad said: ‘We are going to wait for 3 months – if nothing positive comes up I think other regions might follow this plan. We need to safeguard ourselves, there has to be some other way to continue to practice. I don’t intend to leave the country, so I will need to find another way to practice here.’

What happened to GPC’s threat to collect mass resignations from GPs?

The LMCs Conference last May called on the GPC to ballot practices on collecting resignations from the NHS unless an adequate support package was put in place to rescue general practice. 

However, the GPC announced in August 2016 that it would not ballot members on potentially submitting undated resignations or industrial action after claiming that it has won concessions on workload from NHS England.

The GPC said GP ‘reluctance’ over the plan was also a reason for calling off plans, but Pulse revealed that some LMCs are drawing up explosive ‘plan B’ alternatives of their own.

Pulse’s recent survey of 1,000 GPs also showed that half of GP partners are willing to resign the NHS and go private.

In Northern Ireland, the GPC is set to collect resignations by the end of this month.

Readers' comments (11)

  • Why not just change rules. Allow some patients to see their GP private if they wish, others remain with nhs?

    Unsuitable or offensive? Report this comment

  • Charge all your registered patients £100 a year for 3 twenty minute appointments in a year with a GP and 3 with nurse or nurse practitioner or a HCA. Anything over and above that will be extra charge. This will end all our funding problems. Home visit should have an additional charge.

    Unsuitable or offensive? Report this comment

  • Payment per each GP consultation and removing Practice Boundaries - are the only two things that can transform General Practice in the UK. Any other change is bound to fail.

    Unsuitable or offensive? Report this comment

  • Removing practice boundaries must surely be combined with practices having the right to turn away patients if the list is too large. We have grown our practice list by 25% in 4 years - and have no more room for extra staff. If we were not turning away every patient living the other size of the boundary, we would be 25% bigger still, rolling in money, but have nowhere to actually see the patients.

    Unsuitable or offensive? Report this comment

  • Here we go. Now the calls come within our own ranks - and all because we have been deliberately starved. Very sad but I cannot argue against this now.

    Unsuitable or offensive? Report this comment

  • National Hopeless Service

    Don't see how even working through a private company you can treat your own patients privately. There has never been anything stopping us doing minor ops on a neighbouring practices patients.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    You see
    Education has a similar scenario and some schools want to charge a fee:
    Grammar schools 'may ask parents for hundreds of pounds a year'
    By Ross Hawkins

    As I said in my long comment in the weekend , all these are part of the real 'STP'(Sustainability and Transformation Plan' of the government for Brexit and a new relationship with US, China and rest of the world , while it is to hold EU in ransom to strike a free trade deal, by making Britain a tax haven with a very low corporation tax , more infrastructure and technology investment;the money to do that has to come from somewhere i.e.selective austerity in public service sectors.
    What will happen to these amendments ,thrown by oppositions on the government in the forthcoming parliamentary debate on Brexit , is interesting . Chuka Umunna, Labour MP , has a similar argument of mine:
    "So I would like to see, for example, a commitment to put £350m a week into the NHS that Boris Johnson, Priti Patel, Liam Fox and Chris Grayling committed to during the referendum campaign."
    I think if you are interested in this matter , you should bombard MPs' e-mail boxes for more amendment ideas......

    Unsuitable or offensive? Report this comment

  • If this goes through it will be a huge step forward in freeing us from NHS bureaucracy and restrictions enabling us to provide more services because those services will be directly reimbursed. Whilst the capitation based contract has had benefits it inherently stifles expansion of services because there is little additional income attached for extra activity.

    Now we need the BMA to support it and not default to protecting the NHS at the expense of supporting its members.

    Unsuitable or offensive? Report this comment

  • This heralds the end of the NHS, welcome to health care dependent on ability to pay. Private health care leads to overtreatment and overinvestigation of people who can pay, and underinvestigation and undertreatment of those who can't. End of a well laid out 30 year plan. GPs forefront of end of the best health system in the world. Shame on us

    Unsuitable or offensive? Report this comment

  • I have conducted a verbal straw pole of many my patients from all walks of life and nationalities over the last 3 months or so. Most people realise that the NHS is in trouble financially. In France a patient pays the GP a fee & then claims back a significant proportion from the government afterwards, but not all. Top of the list by a long way is being able to charge at least £50 in A&E for someone who attends whilst drunk (Suggest twice over breathalyser limit as a reasonable bench mark). After discussion most people feel the time has come for a £10 charge for a GP or A&E attendance, £20 for a home visit. Probably £20 for any minor surgery procedure. I know it all has to be managed, but if France can manage it, so can we!

    Finally minor skin operations which are cosmetic should be able to be charged for at a commercially competitive rate. Clear transparent guidelines would have to be in place so there is not a conflict of interest. Skin tags & unwanted cosmetic seborrhoeic warts are good examples of such lesions.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page

Have your say