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Use PBC to keep private firms out

GPs should take on practice-based commissioning for 'political' reasons rather than to make money, GPC negotiators are advising.

By Rob Finch

Dr Laurence Buckman, GPC deputy chair, said commissioning was vital for GPs to stop private providers getting a foot-hold in their area.

Failure to get involved and commission existing practices to carry out work would give PCTs the opportunity to bring in APMS providers, he warned.

Dr Buckman said: 'Some PCTs are rumoured to have said they will keep that money [the savings] and practices will want to consider their approach in the light of that.

'The reasons to do it are very simple ­ they are to do with the risk to practices of not commissioning services from yourself and the PCT then commissioning it from an APMS provider. I would encourage every practice to consider practice-based commissioning for practical and political reasons.'

Dr Buckman's comments came amid growing GP anger at recent Government guidance. GPs could only get half of the £1.90 directed enhanced services money for commissioning and might also see any savings they make taken by PCTs to pay off deficits.

The guidance, Achieving Un-iversal Coverage, also confirm-ed practices will have their indicative budgets pegged back by PCTs to this year's levels.

The decision benefits practices with a high level of referrals but makes it harder for low referrers to save money.

Future budgets will be work-ed out on a 'fair shares' basis. But the formula for calculating allocations will only take into account the age and sex of the population ­ not deprivation or ethnic mix.

Dr Ian Harper, a member of the Nelson Commissioning Group and a GP in Wimbledon, south-west London, said practices would be hamstrung by low budgets because PCTs would focus on balancing their books.

Dr Geth Jenkins, secretary of Leicestershire LMC, said the guidance had 'deflated everyone's enthusiasm'. He said: 'The main difficulty is going to be with validating the data ­ the only people who have the data are the PCTs.'

Dr Phil Taylor, a GP in Axminster, Devon, who is researching 'gaming' in commissioning, said the rules were 'subject to local interpretation'.

He said: 'There is an unfairness in using historical budgets ­ it's vital to move to fair shares but if it's not on current data it's worthless.'

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