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Was using the Carr-Hill formula in the contract a cock-up or a conspiracy?

Cock-up or conspiracy? It was naive of the GPC to agree to some formula without trialling it first to check it against reality. I find it difficult to believe the GPC or the NHS Confederation weren't aware of the weightings. If they weren't it was a cock-up, if they were.....

The GPC should have known better. In May 2002 I wrote saying the obvious clear source of data for morbidity was practice disease registers. These could be audited by the PCO. They could also be used to give the absolute basis for target payments. I wrote to Professor Carr-Hill later in the year with the same advice. Neither deigned to reply.

GPs need to remember that even when they have ploughed through the calculations, the contract allows the Secretary of State to change terms and conditions with just three months' notice (consultation). That gives GPs less protection in some aspects than the present Red Book.

Before the notional list weightings were published we were told most GPs would be winners. Afterwards it transpires most are losers. How reliable are any other GPC predictions? Caveat emptor!

Dr Paul Meadows

Knowle, Bristol

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