A GP whose legal action with 19 colleagues to prevent PCTs unilaterally terminating PMS contracts failed last week has become one of the first to have his contract cancelled under the controversial measure.
The High Court last week handed PCTs the right to unilaterally cancel PMS contracts with just six months' notice after ruling against a group of 20 GPs who were challenging the right to use a controversial new termination clause.
In his summing up, Right Honourable Justice Nicol revealed NHS Greenwich had already used the power to terminate the contract of one of the GPs who had taken the legal action, Dr Karim Jan-Mohamed.
Dr Jan-Mohamed and the other GPs brought the case following moves by NHS Havering and NHS Greenwich to write in 'variations' to PMS contracts GPs claimed could be used to impose cuts in funding of as much as 40%.
The legal challenge was seen as a key test case for the almost half of practices in England working under PMS contracts, with fears it now leaves them open to aggressive efficiency reviews.
Barrister Simon Butler from Ely Place chambers, representing the GPs, argued GPs had been led to believe they were on permanent deals and that former secretary of state Andy Burnham's 2010 PMS regulations were 'inconsistent' with the 2004 regulations.
But the High Court disagreed. Justice Nicol said: 'In my judgment the claimants have not shown a reasonably arguable case. I would refuse all claimants permission to apply for judicial review.'
The Judge rejected questions over the legality of the 2010 Regulations: 'In my judgment, it was within the statutory power of the Secretary of State to make them.'
He added: 'I have noted Greenwich (but not Havering) has exercised the new power to terminate Dr Jan-Mohamed's PMS Contract. As I understand it, while this will bring his PMS contract to an end, he will still have the option to switch to GMS. That alternative may not be as financially attractive, but it may provide some assistance.'
Dr Peter Smith, a PMS GP in Kingston and vice-president of the National Association of Primary Care, said: 'Enlightened PCTs have not gone down the termination route. It's a blunt instrument, and indicative of a PCT that's failed. PCTs should be using PMS to drive up quality, not as a cost-cutting exercise.'