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Gold, incentives and meh

Peak-flow meter plans don't work

GPs are threatening to boycott the Government's Choose and Book initiative unless primary care trusts provide extra funds to cope with an expected increase in workload.

The project, a central plank of the National Programme for IT, is being piloted before a nationwide roll-out by the end of 2005.

The plans mean GPs offering patients a choice of up to five hospitals during a consultation. But GPs said they would refuse to sign up unless extra funding, possibly as a local enhanced service, was made available to help with administration costs and extra workload.

Northern Lincolnshire and East Yorkshire LMCs last week called on GPs not to offer patients choice of hospital unless PCTs paid for Choose and Book as a local enhanced service.

The LMCs' medical secretary, Dr Russell Walshaw, said the Government had forgotten that GPs were free to refuse to handle the initiative. 'It is not in the new contract and the GPC has not been consulted,' he said.

'As far as I can see it is designed to enhance the service locally and should be paid for accordingly.'

Dr Stephen Fox, a singlehanded GP in Leigh, Lancashire, said he supported calls for extra funding and was furious about perceived extra demands being made on his time.

He said: 'I won't do it as it stands at the moment. What I want to do is to see patients, not be a bean counter for the Government.'

The scheme has been piloted in a handful of practices in north London and Yorkshire. GPs in those areas have reported delays due to technical difficulties.

Dr Kambiz Boomla, chair of City and East London LMC, which covers one of the pilot areas, said one problem reported by GPs involved

was that the software used

was not compatible with 'ancient' systems used by local hospitals.

'It goes further than issues of funding,' he said. 'What the Government is proposing in terms of deadlines just won't work. The whole initiative is ill-conceived.'

The Department of Health has insisted that Choose and Book would not have a detrimental effect on GP workload. A Government- funded study, published in April, claimed the initiative would add just 36 seconds to consultations.

GPC member Dr Brian Balmer also backed the tough stance. 'If there is not funding then there is no service. It's as simple as that,' he said.

By Ian Cameron and Joe Lepper

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