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Quality pay 'unfair and intolerable'

Disgruntled GPC members have turned their venom on the quality framework, branding it 'unacceptable and unfair'.

The 'intolerable' payment system penalises GPs working in high-morbidity areas as well as any practice that ditches the discredited Carr-Hill formula in favour of the minimum practice income guarantee (MPIG), they complain.

The revolt ­ said to have 'united' the GPC ­ will come as a devastating blow to GP negotiators, following hot on the heels of the Carr-Hill fiasco and widespread dissatisfaction with MPIG.

Negotiators had hoped the prospect of large quality payments would tempt GPs towards a Yes vote. They admit some practices will have to work harder for the same quality pay but claim the unfairness is no worse than under the Red Book.

GPC member Dr Fay

Wilson said: 'The quality framework is not acceptable.'

MPIG practices faced a double whammy. Their payments would be weighted according to the original Carr-Hill formula and they would have 100 points docked in the first year and 150 in the


GPs in deprived areas would also lose out.

Dr Wilson, a GP in Birmingham, added: 'The framework contains intolerable inequities between practices with wide variations in prevalence of different conditions. There is a perverse incentive against effort in areas of real need.'

A practice with 5 per cent diabetes prevalence would be paid the same as a practice with 1 per cent prevalence, meaning GPs could cut the workload involved in earning points by failing to diagnose patients, she added.

Dr Rob Barnett, GPC member and secretary of Liverpool LMC, echoed her anxiety. 'I am extremely concerned because payments do not take account of workload. I don't think it is equitable.'

Dr Mustafa Karpasi, a Scottish GPC member and a GP in Inverclyde, said the GPC was united in its concerns. 'Everyone is agreed that the perverse incentive has to go.'

GP negotiator Dr Andrew Dearden said: 'It's true some GPs will gain more than others. But if you look at the differences between Red Book payments now they can be equally wide and have nothing to do with workload.'

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