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Quality checks in chaos as GPs face two PCT visits

PMS is set to 'wither away' because primary care trusts are imposing block contracts on practices which stifle all local innovation, according to a GP pioneer of the scheme

Dr James Kingsland, chair of the GPC PMS sub-committee and a former Government adviser, said the scheme had 'gone pear-shaped' and he 'questioned the point' of having separate contracts.

His comments came as the GPC warned hundreds of PMS practices not to sign new PCT-imposed contracts because trusts had omitted vital clauses on pay, pensions and allowing LMC protection in the event of termination.

Negotiators told practices to defy 'strong-arm' tactics by trusts to meet the September 30 deadline for moving from pilot to permanent status because BMA lawyers had found 'significant' faults.

These included giving PCTs the power to vary payments arbitrarily and not ensuring superannuation contributions were equivalent to GMS practices.

GPC deputy-chair Dr Laurence Buckman said: 'In the contracts we have seen there's nothing to stop PCTs reducing the baseline. Do not sign.'

Practices that signed faulty contracts could challenge them if it was clear they would be disadvantaged because they were not made aware of the problems, he added.

Practices that did not sign by October 1 would operate under the new 'core' regulations ­ equivalent to the GMS statement of financial entitlement ­ and are in no danger of income being withheld.

Dr Kingsland said he was 'bewildered' by PCTs' policy of imposing PMS contracts on groups of practices rather than negotiating individual agreements according to local circumstances. 'The idea of standardised contracts is not PMS and makes me question if there is any point in having a separate PMS arrangement.'

'The whole point of PMS was about negotiating locally but it's got lost in the financial debate, become target-driven and now we have pseudo-national negotiations.'

By Ian Cameron

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