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PMS: take pay cut or lose contract

U-turn on PMS signalled in instructions to ensure all practices are funded in a similar way

PMS GPs must agree pay cuts to bring their income into line with their GMS counterparts or face being stripped of their contracts, the Department of Health has ordered.

Guidance to PCTs issued this week demands they 'constrain' payments to PMS GPs from April and ensure all practices are 'treated in a similar way'.

PMS practices must get zero uplifts in line with the GMS

'efficiency savings', it says.

Where PCTs have already agreed income rises for PMS GPs, they must negotiate 'additional efficiencies' which have the effect of wiping them out.

If practices fail to agree a deal, PCTs will 'need to consider ­ taking legal advice where necessary ­ the continuing appropriateness of the existing contract they have with that pro- vider', the guidance says.

The move marks a U-turn in the Government's attitude to PMS. It gave out thousands of pounds in growth money to GPs to entice them to switch to local contracts between 2000 and 2004.

The result is the 40 per cent of GPs with PMS contracts earned £17,000 more on average than GMS GPs last year.

But with NHS finances in crisis and internal anger at rising GP pay, ministers are now desperate to claw back whatever they can.

Dr Stewart Drage, GPC negotiator, said: 'This signals a change in attitudes to PMS. They are within their rights to monitor contracts, but it's a bit rich to say that PMS practices need to be reined in.'

He added it would be 'grossly unfair' to claw back PMS earnings unless disputes procedures proved GPs had misused them.

Former health minister John Hutton pledged in 2003 that PMS contracts would not be 'unpicked' to strip GPs of growth money. A spokesman for the department denied that was now the aim.

'It's about getting better services for patients,' he said, 'This is a reminder to the NHS of something it should have been doing already.'

But PMS GPs said if the Government wanted to level out income, but was not putting more money into GMS, there was only one conclusion to be drawn.

Dr David Bevan, a PMS GP in Upwell, Cambridgeshire, said: 'If contracts get aggressively revisited in order to only level down, without taking into account levels of clinical service, that should be vigorously resisted.'

A full review of PMS financial arrangements was announ-ced in the Our Health, Our Care, Our Say White Paper.

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