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At the heart of general practice since 1960

PMS powers prompt two-tier fears

PMS GPs can negotiate their own quality framework and opt out of offering basic services under a series of new powers handed down by the Government.

The rights, announced by health minister John Hutton, re-establish clear water between PMS and GMS contracts but have prompted fears of a continuing pay gap.

Mr Hutton told the National Association of Primary Care PMS practices would keep existing growth money, have access to the new quality money, and would be 'entirely free to develop local variations of the quality framework'.

GP negotiators attacked the move and said Mr Hutton must maintain equity between the contracts.

GPC joint-deputy chair Dr Hamish Meldrum said: 'We spent a lot of time making sure the framework is evidence based and we do not want to see people substituting things.'

Plans for new Specialist PMS practices means some GPs can opt out of offer-

ing basic care and provide

specific services such as minor surgery.

Mr Hutton said Specialist PMS would be like PMS Plus practices 'having a Plus contract only'.

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