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Independents' Day

Thousands of GPs plan to shun the new DESs

By Ian Cameron

Thousands of GPs are refusing to participate in new directed enhanced services.

Results from Pulse's Contract 2006 survey show more than one in three GPs will not take part in the information management and technology DES next year.

A quarter are opting out of the Choose and Book enhanced service and one GP in five is to ignore the practice-based commissioning DES.

Even on the access enhanced service, thought to be the easiest of the four, 12 per cent of 329 GPs who responded are refusing to take part.

GPs who planned not to do the DESs said their refusal was either in order to limit workload or a protest against political targets they did not believe benefited patient care.

The four enhanced services combined equate to £4,30 per patient, or around £25,000 for an average practice.

Dr Joseph Booker, a GP in Coventry, has refused to participate in any of the four enhanced services. He said the Government's choice agenda was an 'absolute joke' and he had not found any patient benefit from new IT systems.

As a singlehander he said he was too small to do practice-based commissioning and that local plans were 'woolly'.

He said: 'I can't see any of them being any use to patients. There are no carrots, only sticks.'

Dr Paul Searle, a GP in Eaton Socon, Huntingdonshire, said he was disillusioned by the focus on computing in modern general practice and would not be signing up to either the Choice and Booking or IM&T DESs. He said he was refusing to 'play the game' over access.

'There's not enough time to deal with real people anymore. I'm not getting a lot of job satisfaction because of computers dominating our lives.'

Dr Laurence Buckman, GPC deputy chair, said most practices would base their decision on the economics of providing a service, while others would 'conscientiously object'. Dr Buckman added: 'The DESs are the best we could get.'

He said it would be 'foolish' for GPs to sign up to a DES with no intention of participating, as PCTs could claw back money if service levels were not met.

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