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Practice boundary discussions falter

By Gareth Iacobucci

Talks on how to introduce the Government pledge to scrap practice boundaries have ended with no practical solution in sight, say GP leaders. In fact they warn the plans will play havoc with PCT finances

GPC chiefs have revealed that – despite protracted discussions - the DH has failed to come up with any information on how health secretary Andy Burnham's plans will succeed when all previous attempts have failed.

Last month Mr Burnham promised to rip up practice boundaries within a year but after searching for potential answers to the huge logistical barriers facing the idea, GPs leaders said they had come up short.

GPC chair Dr Laurence Buckman said discussions had centered on ‘feasibility, not desirability' of the proposals but said the GPC could still see no way of solving the issues involved.

He said these include how to organise home visits, transaction costs and referrals for patients being referred in one place but living in another.

Patients registering at two different practices is another solution which has previously been discussed but abandoned because of the cost implications.

Dr Buckman said after the GPC meeting: ‘PCTs are entirely funded on their population. If you don't know who your population is, it's difficult to see how you would fund it appropriately.'

Fellow negotiator Dr Chaand Nagpaul urged the Government to explain how it thought the move to get rid of barriers would work.

‘Beyond the political headline, the DH has produced no information about how they actually see this being implemented,' he said. ‘It raises a Pandora's Box of very complicated issues. It will be interesting to see how they implement it within the stated timescale.'

The DH said: 'We will work closely with GPs and other NHS stakeholders to discuss how we can design a system that gives people a greater choie. We will set out our plans shortly.'

Dr Laurence Buckman

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