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U-turn over increased GP role in drug misuser care

The Government spent £1.3 million to get an extra 4 per cent of GPs involved in treating drug misusers last year. But ministers are now admitting they have scrapped their target to involve one in three practices in shared care programmes.

The National Treatment Agency last June set a target to involve 30 per cent of practices with the aim of doubling the number of misusers getting help to 200,000 by 2008.

New figures show GP involvement only rose from 19 to 23 per cent last year despite an extra £1.3 million spent on training GPs.

Now GP advisers to the agency are warning that most of these GPs ­ many successfully treating just a handful of users ­ are likely to have to pull out because drug misuse treatment has been 'overpriced' as an enhanced service.

GPs treating drug misusers will get a £1,000 annual retainer plus £500 per withdrawal and £350 per maintenance payment under bench- mark pricing.

The Department of Health said the Government was now less concerned with getting more GPs involved than with meeting its 200,000-patient target. Its '30 per cent of GP practices' target was just a 'means to an end', said a spokeswoman.

Dr Clare Gerada, a member of the agency's expert prescribing group and director of the RCGP drug misuse training programme, said she feared the price of the enhanced services for drug misusers would undermine efforts to boost practices' involvement ­ ranging from 80 per cent in Lambeth to just 5 per cent in some parts of England.

Dr Gerada, a GP in Lambeth, south London, said: 'We've worked hard to get some coverage across the country, but we might have things pulled away from us with the new contract ­ I have an awful fear it might affect us for the worse.'

PCOs struggling to fund mandatory directed enhanced services were having 'fashion shows' to decide which services they commissioned, she said. 'They'll look twice at paying £1,000 for a doctor seeing one or two patients.'

Fellow prescribing group member Dr Jenny Keen said a fall in GP involvement would be 'disastrous' but understandable if GPs snubbed misusers over funding cuts.

Dr Keen, clinical director of the Primary Care Clinic for Drug Dependence in Shef-field, added forcing users elsewhere for treatment would compromise trust GPs had worked for 'years' to build.

GPC joint-deputy chair Dr Hamish Meldrum said it had agreed the pricing as 'reasonable' after taking advice.

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