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Gerada: Contract changes threaten patient care



Exclusive: The chair of the RCGP has waded into the row over the Government’s proposed contract changes, warning that the QOF is ‘out of control’ and the planned withdrawal of MPIG poses a ‘serious risk to patient care’.

Dr Clare Gerada told Pulse she was concerned that the planned phase-out of MPIG removed an important protection for GP practices ensuring that they would not be allowed to go bust even if their income plummets.

She said that this move was part of a drive to remove barriers to new providers of GP services, such as private companies.

Dr Gerada also said that she was concerned that the QOF was getting ‘out of control’ and was distorting the care that GPs provided, and needed ‘concerted effort’ by the GPC and the RCGP to reverse mission creep.

The intervention marks a watershed for the RCGP, which normally tries to remain impartial over contract negotiations, and comes at a sensitive time, with the BMA preparing its response to the Government’s proposals on how the GP contract should change in 2013/14 published last week.

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Dr Gerada said: ‘The important issue here is [that] the removal of the MPIG means that there is a serious risk of patient care being undermined.

‘MPIG is a device to ensure continuity of GP services by preventing them suddenly going broke. Its removal will have the effect of restoring that risk.

‘I worry that the Government has an agenda that means that it is not protecting GP practices (and NHS hospitals) from going bust. Some say this is because the economic models that they use to justify privatisation insist that there must be minimal entry and exit barriers to the new NHS mixed markets, so that new providers can start providing services with the minimum of formalities.’

‘For new providers to be able to enter the market, old ones have to be able to leave it, and the removal of the MPIG is the removal of such a barrier.’

She added: ‘The practical implications of such a change are significant beyond the GPs who will be driven out of business by it: the replacement providers are likely to be insurance companies or outsourcing companies about whose services quality concerns have already been raised.’

With regards to the QOF, Dr Gerada said on the social networking site Twitter: ‘Few QOF targets are meaningful. They distort care towards what “medicines” can Rx.

‘QOF is risking driving out caring and compassion from our consultations. We need to control it before it gets more out of control – need concerted effort by GPC and RCGP.’