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GPC: Contract imposition ‘is all about saving money’



A leading GPC official has said the Government’s wide-ranging QOF changes proposed as part of its GP contract imposition are financially driven and not patient driven as the Government has suggested.

Dr David Bailey, Welsh GPC chair, branded the English policies as ‘bad medicine and bad government’ when interviewed for Pulse’s Big Interview video series last week.

The DH is making a ‘huge mistake’ in pushing ahead with its contract imposition, he said, and warned that it would lead to a recruitment crisis in England in the long run.

He said: ‘We are continuing to talk to people at the Department of Health and we are continuing to explain the problems we have with the imposition and why we think that they should look at changing it to something that is more manageable, to something that does not focus practices too much on a narrow, box-shifting way of delivering general practices and away from the professionalism of GPs and the professionalism to provide holistic medicine to patients. We think that is being lost more and more by a Government which seems determined to put in more and more targets rather than allowing us to be professionals.

‘Although they say that it is patient driven, a significant driver is clearly financial, and they expect the amount of money they pay to GPs to drop next year. They say they don’t, but I don’t believe that at all. We think that this will be a significant problem for practices, to remain financially viable next year.’

‘So, I think it is all about money. To some extent I think that is always what the English Government has been focused on [but] the sponge is sodden and it is dripping on the carpet and I just don’t see how much more capacity GP practices have to absorb.’

He went on to criticise the heavy focus on the QOF in general practice and said the Government does not understand what professional, holistic general practice is.

He commented: ‘QOF is still a very narrow set of criteria. QOF doesn’t cover the whole human condition. This is accountancy thinking, not medical thinking. Most incentive schemes in other walks of life don’t make up 40% of your entire income. Ten percent or 15% might be something that people could live with a bit better. QOF doesn’t measure everything, it doesn’t even measure most of everything. Government trying to force everything into those small number of measurements is bad medicine, it is bad government and it is by a Government which doesn’t understand what professionalism and what providing good, holistic care for patients is all about.’

But, despite the harsh criticism from doctors, Dr Bailey does not think that the DH will budge from its imposition.

He said: ‘I think it is very unlikely that they will reconsider. The secretary of state has said they are consulting, but the tone of his letter seems to be quite clear that there is no real appetite for turning.’

‘We hope that we will persuade them that one or two of the stupidest things, like moving from 15 to 12 months for [QOF] reviews, some of the minor issues of detail in the contract relating to QOF which we think will actually be bad for patients and bad for the doctor-patient relationship – we hope we might persuade them on the peripheries of that.’

‘But do I think that they are going to change the grand thrust of their imposition? No I don’t think they will.’

Click here to watch the full video with Dr Bailey, where he discusses the Welsh GP contract, pensions, GP premises and the English contract imposition.