PCT windfalls raise contract cash hopes
The Government has given a clear signal that the new contract will be backed with significant extra cash after it announced a 30 per cent hike in PCT budgets last week.
Trusts will get £45 billion next year and £148.3 billion in total over the next three years, with the average trust set to receive £42 million in 2003/4.
The increase outstrips growth in total spending on the NHS and is the first real evidence of the Government's supposed switch in priorities towards primary care.
Trusts will now control 75 per cent of the NHS budget, but GPs have raised fears that new money for GP infrastructure costs contained in the allocation will be spent on other things as trusts grapple with secondary care targets and rising prescribing overspends.
The spending allocation for trusts does not include new contract money, but is supposed to cover GPs' staff costs, computers and cost-rent.
GPC joint-deputy chair Dr Hamish Meldrum said he expected most of the new money to go into primary care but that the GPC still expected 'substantial resources' for the new GP contract to follow.
He added that trusts would not be able to get their hands on any new money for the contract because of the funding flows that will ensure the cash goes directly to GPs.
'It is clear from the framework document that we will be ensuring that the money for primary care is protected so that it actually ends up in primary care and doesn't get diverted to pay for overspends in other parts of the trust's budget,' Dr Meldrum said.
Those involved in the contract negotiations were divided over whether there will also be additional money for GPs' infrastructure costs in the
Chris Town, a member of the NHS Confederation core negotiating team, said he did not expect extra primary care development money in the first year. 'We are more optimistic for years two and three,' he said. 'I would not try to raise peoples' expectations that there is money for new primary care services in year one.'
However, Dr David Jenner, a member of the NHS Confederation's contract reference group, said he expected more money for computers, staff and infrastructure to come with the contract.
PCT budgets for the next three years:
Trusts getting biggest increases in funding: %
Tower Hamlets, London 42.61
Barking and Dagenham, Essex 42.48
Tendring, Essex 41.75
Knowsley, Merseyside 40.92
North Liverpool 40.62
Easington, County Durham 40.56
Average increase in PCT budgets 30.83
Minimum increase 28.08
Total PCT spending allocation 2003/4 £45.027 billion
Total NHS spending in England 2003/4 £61.3 billion