PMS disputes 'a cautionary tale'
Problems with PMS across the UK illustrate the dangers of moving away from a nationally negotiated agreement, the GPC has warned.
Dr Hamish Meldrum, GPC chair, rejected last week's calls by ex-health minister Lord Warner for an end to a national contract.
He insisted all GP contracts should have a nationally negotiated core component to protect GPs' ability to provide services in deficit-stricken areas.
Some local flexibilities could be built in using locally negotiated 'add-ons', he said. 'Anyone given a contract to provide core NHS work should do that to national terms and conditions. For non-core work, there's no reason why everybody should have to reinvent the wheel.'
Dr Meldrum said experience with PMS had demonstrated the drawbacks of local contracts. 'Because PMS is local, a lot of PCTs are treating it differently and threatening it in one way or another.'
He wanted to preserve the system where all practices providing core services did so under a nationally negotiated GMS contract and arranged their own local 'add-ons'. Alternatively they could have a local contract but with core services priced at national rates.
Last week, Lord Warner told Pulse he expected a move away from a single national contract, with much greater local flexibility in future.
But Dr Meldrum said leaving the whole contract to be negotiated locally would be 'an absolute nonsense'.
'Seeing what's started to
happen with PMS, you will find that PCTs, particularly those in financial trouble, will look at areas where they can try to make cuts. Because of the way GPs are paid, where pay depends on profit they make doing the job, GPs would be forced to cut services and sack staff.'
In recent weeks, PMS practices in Leeds and Coventry have experienced just this scenario when PCTs have attempted to review their contracts.
Leeds PCT has now agreed
to work more closely with
practices and set up a focus group to standardise PMS arrangements in the city.
In Coventry, the PCT had written to practices requesting termination of contracts in six months, but has now removed the notice of termination.
Dr David Shubakher, Redbridge and Waltham Forest LMC chair, said 25 PMS practices in his area had banded together and hired Lockharts solicitors to negotiate with their PCT over contract changes.