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Gold, incentives and meh

Sauce for the goose ...

This Government is starting to make a specialty out of U-turns.

It started life by scrapping GP fundholding and health authorities in favour of PCGs, and then PCTs. Now they're being replaced by eerily familiar large PCTs and practice-based commissioning.

PFI hospitals used to be the thing. Now they're the wrong thing. On community hospitals it's the other way round. Then there's PMS. Between 2000 to 2004, there was a mad rush to get GPs to ditch their national contracts, negotiated by the BMA, and take on local contracts.

Thousands of pounds were thrown at GPs to get them to switch. Early on, most practices followed the ethos of PMS by innovating and developing tailored local services.

But after the Government set its arbitrary target to get one in three GPs into PMS, more just took the money. And they can't be blamed for doing it. Just ask Tony Blair. If a benefactor with deep pockets offers money, you are hardly going to turn it down are you?

Level up, not down

Now the Department of Health coffers are empty and it wants its money back.

Yes, it is right that practices doing the same work should receive the same resources. But the threat to strip PMS GPs of their contracts if they do not agree to real-terms pay cuts is indefensibly aggressive.

Having dished out more money to one set of GPs, the way to even things out is to level up, not down.

GPs should not be made to suffer for a situation which is purely of the Government's own making.

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