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At the heart of general practice since 1960

Software delays hit GPs' pockets

When Emma Wilkinson visited the Prime Minister's Sedgefield constituency, she found GPs in upbeat mood

The drive from Durham train station into the heart of Tony Blair's Sedgefield constituency passes immaculate cottages, country pubs and a sprinkling of genteel English tea shops.

It is hard to believe that Sedgefield is one of the most deprived areas of the country, but the statistics are stark.

Teenage pregnancy rates are 28 per cent above the

national average and life expectancy is two years lower. Sedgefield village may be a pocket of pristine affluence, but in the crumbling industrial areas surrounding it, five of the wards are in the country's most deprived 10 per cent.

If anywhere might be expected to have struggled with the demands of the new contract, it is here.

'All the things you think of when you think of deprivation are issues for us: a lot of above-average prevalence of illness and lung cancer rates are high,' said Dr Dinah Roy, PEC chair and LMC member.

But Dr Roy, a singlehanded GP in Spennymoor, was resolutely on-message as she enthused about the benefits of the contract.

'All practices have performed very well under the new contract and have achieved well above aspiration,' she said.

Dr Roy believes much of the success is the result of a long-standing tradition of good relations between local GPs and the PCT and well organised local services.

'We had specialist nurses in CHD and a high level of computerisation. We're used to disease registers,' she said.

Dr Andrew Sanderson, also a GP in Spennymoor and vice-chair of the PEC, said he would be surprised if any practice in the area had achieved less than 1,000 points. 'The quality is very high in Sedgefield,' he said. 'Of the 11 practices, seven have the RCGP quality award.'

Even the proliferation of targets which has so riled GPs elsewhere seems to have gone down well here.

'There is a lot of hoop jumping and box ticking but I think that is the way it has to be,' said Dr Geoff Walker, a GP in Newton Aycliffe. 'There are probably fewer people having heart attacks and blood pressure is coming down.'

Dr Walker has concerns over Government policy on primary care, worrying that 'the PCT gets its budget and a huge chunk goes off to pay hospitals without any consideration of how it's being spent'.

But even here GPs feel a New Labour innovation could provide the answer. 'We're hoping practice-based commissioning will turn it around,' Dr Walker said.

Not that serving the health of the Prime Minister's constituents appears to earn any special favours ­ although GPs conceded Mr Blair might have had a hand in the area's shiny new community hospital.

Among the picture postcard villages and struggling ex-mining towns, there are further signs of New Labour's modernisation of the health service at work. Last year, one of Sedgefield's practices agreed to hand over management duties to a private company called

Intrahealth (see below).

The move must have pleased the Prime Minister, who is urging 'entrepreneurial GPs' to get more involved in running services.

Sedgefield may be an old-fashioned, traditional kind of place, but New Labour values are alive and well.

How GPs are achieving against the odds

· Death rates for lung cancer in Sedgefield are

46 per cent above the average for England and Wales, mortality from circulatory disease is

21 per cent higher and teenage pregnancy rates

are 28 per cent higher

· Seven of the 11 practices have the RCGP

quality award

· At least nine of the 11 practices have achieved more than 1,000 quality points

GP sings praises of private takeover

Dr Ian Walton, senior partner at Hallgarth Medical Practice in Shildon, had been working with Intrahealth for several years before finally signing over managerial duties in December 2004.

'I had considered reducing my time commitment. Reducing the management and retaining the clinical component seemed ideal,' he said.

Dr Walton and his two GP colleagues are now employees of the company. Dr Walton says the move has given him a steady income and improved patient care without compromising his autonomy. 'I actually enjoy my work more now. The practice has benefited from increased GP session time and extra staff, and freeing us to focus on the clinical job.'

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