Exclusive The abolition of practice boundaries is to form a key battleground between the Government and the GPC during this year's contract negotiations, as talks begin over next year's deal for 2012/13.
Ministerial sources have told Pulse the Government is determined to press ahead with the controversial policy by next April, despite the GPC's fierce opposition to the move.
The Government's stated aims of moving to a single GP contract and incentivising practices to take on patients in deprived areas are also expected to be discussed in this year's talks,although it is unlikely a firm announcement will be made on either by next April.
Sources insist ministers are mindful of the profession's concerns, but are basing negotiations on the basis that they believe relatively few patients will change practices when boundaries are abolished.
Dr Paul Charlson, chair of Conservative Health and a GP in Grimsby with close links to ministers, said the policy would be one of the key ‘bargaining chips' in this year's negotations.
He told Pulse: ‘I think the DH realises it has got to be sensible and feasible. One of the things the Government probably has learnt is that you've got to carry the profession with you because we've witnessed over the last six months what can happen if you don't.'
Dr Charlson said GPs could be offered direct payments to cover home visits as part of the deal. ‘Some practices might make a business out of providing a visiting service for a town', he added.
GPC negotiator Dr Peter Holden said the policy as outlined by Government was ‘not workable'.
He said: ‘The GPC offered a solution but ministers are being pig-headed about it in the face of sensible advice from their advisors.'
He added: ‘A free-for-all will cause trouble. It becomes a nightmare from a budgeting point of view, there are very serious professional concerns about those who will go practice-hopping to get hold of medication, or because there is some problem with child protection. Practice boundaries provide checks and balances.'
A DH spokesperson said: ‘The vast majority of patients told us that they want to be able to register with a GP practice of their choice in our consultation on practice boundaries. We aim to give patients far greater choice of GP practice from April 2012.'
On the table for discussion:
- Practice boundaries
- Unified GP contract
- Incentives for treating patients in derived areas