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At the heart of general practice since 1960

Put care before profits

From Dr Lydia Stevens, Brentford, Middlesex

PCT-run practices seem to get bad press from just about everyone except patients. There seem to be misconceptions about why we may not have fulfilled the hopes of cheap, high-quality care.

PCTs generally took over failing practices ­ that is why new GMS partners could not be attracted to them. They are socially deprived areas with high disease prevalence decades of under-funding, under-doctoring and sub-standard care.

To turn around such a practice is never going to be cheap, as several years of work needs to be fitted into one or two years, whoever is doing it. There can be start-up costs too.

The BMA-suggested salaried GP contract suggests a full-time 37.5-hour week which includes a session of continuing professional development, equating to far less time than the average full-time GMS partners, and for a good reason ­ we are paid a lot less! Otherwise we are doing the same job, including management and bureaucracy.

As regards to the QOF points, it is true we have little incentive to achieve very high points, so most of us concentrate of doing the clinical work which benefits the patients, rather than point-chasing in ways which may not benefit patients directly.

Also, as high achievement would merely mean the PCT finding more money, there is a disincentive for them to support us achieving highly, eg with IT help. This doesn't equate to poorer quality care ­ much of QOF has more to do with the way you record the work you are doing than what.

The selling off of PCT-run practices will mean the end of the only part of primary care that puts patient care before profits, and many of us will no longer wish to stay in such posts if we are merely creating profits for private companies.

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