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Why pay PMS GPs more for doing the same job?

From Claire Morgan and

Dr Hank Beerstecher, Sittingbourne, Kent

We are glad that your recent story about our research comparing the cost of providing services via GMS and PMS has been of interest. However, Dr Bill Spiegle (Letters, 16 November) has misinterpreted some of our findings.

Until now, GMS and PMS could not be compared on a like-for-like basis.

The beauty of our approach is that we made the funding for GMS and PMS comparable by looking at the provision of essential services. GMS practices are paid MPIG for delivering these. It is true we could perhaps not precisely match PMS or EMS (employed medical services) pay for this, but if anything we have underestimated their pay, and it is possible PMS/EMS is paid slightly more than we think for providing the same services.

Although it is true that the PMS practices in our sample had a few more QOF points on average, this difference is not statistically significant. Indeed, the same can be said for the whole of the UK (8,574 practices), where the average GMS score was 960.7 and PMS score 956.6. The slightly lower average PMS score is due to most EMS practices being mislabelled as PMS. Correcting for this, GMS and PMS practices are, on average, scoring the same.

We have therefore not weighted any difference of QOF score in our sample, but simply looked at the cost for the same essential services, delivered presumably to the same standard and quality. GMS delivers the same service for less cash.

Surely even Dr Spiegle

must agree that if he were delivering the same service for less money, he'd have to be more efficient? Primary care

is paid for by public monies and we are concerned the Government is not spending wisely.

If all PMS practices had performed as well as Dr Spiegle's, perhaps there might have been an explanation for the extra cash afforded to PMS. As things stand, it is difficult to see why PMS is paid more for doing the same job.

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