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Overseas-trained GPs 'hinder commissioning'

By Steve Nowottny

A PCT chief has caused controversy by claiming singlehanded overseas-trained GPs are a major obstacle to effective commissioning.

Gina Shakespeare, chief executive of Luton PCT, told the NHS Employers conference in Birmingham last week that singlehanded GPs with a ‘gold-plated' contract were getting in the way of reforming local markets.

‘What do you do in inner-city areas such as mine when you've got a lot of overseas doctors who came and set up singlehanded practices 20 and 30 years ago?' she asked.

‘They're the only people who work there, and now they're no longer looking like they've got the capabilities to give us what we want to commission in primary care but they're clinging on to a gold-plated contract that gives them jobs for life.'

Ms Shakespeare also attack-ed the commissioning skills of her PCT staff, saying the situation was ‘critical'.

Few, if any, of her commissioning staff would be able to pass a test on actuarial methodology, she added, and other skills were also in short supply.

‘The competencies for getting the absolute best world-class spot price for biros are probably a bit different from the competencies needed to tackle death and deprivation.'

Her singling out of overseas-trained singlehanders was condemned by Dr Prasad Rao, chair of the British International Doctors Association, who said GP disengagement towards commissioning was widespread.

He said: ‘It's nonsense to say overseas doctors who set up singlehanded practices aren't capable of commissioning. Enthusiasm does vary across the board, whether you are in a singlehanded practice or a bigger practice. Some doctors in bigger practices have no interest at all.'

A recent Pulse survey showed a massive waning of GP confidence in practice based commissioning. Dr Rao said GPs would deliver better commissioning ‘if given good incentives'.

One singlehanded GP in Luton, who did not want to be named, said there was no basis for the claims, and it was too early to judge practices' performance on commissioning.

He said: ‘We have been hitting all our targets, and are not doing worse than bigger practices. If we're not delivering, they have to tell us.'

He added: ‘Commissioning is still a baby. You have to give it two or three years. They should wait and see, rather than saying in advance that we're not capable without giving us time.'

Dr Prasad Rao: nonsense to single out overseas-trained doctors Dr Prasad Rao: nonsense to single out overseas-trained doctors

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