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DH rethinks practice training levy fee after GP opposition

The Government has signalled a rethink over plans for all practices to pay a new levy for the training of doctors, after GP leaders said the proposal could lead to an 'exodus' of senior GPs.

The RCGP had warned that general practice could be destabilised if the Government pushed ahead, while the GPC said it was unfair to expect GPs to pay to train future doctors.

The plans originally stated that all healthcare providers should pay a levy for the education and training of doctors to replace current Department of Health funding for deaneries, but this is now being looked at again.

The levy was to be paid to the new local education and training boards – due to be authorised next month – but the Government said this month that in response to a ‘diverse range of views' over the payment, work was now ‘ongoing' into how the levy would work.

The DH rethink came after MPs on the Commons health committee said there was ‘slender evidence of progress in converting this policy into a system that will work in practice' in their report into NHS education, training and workforce planning, published in May.

The DH response to the report, published this month, confirmed that more work needed to be done before ‘firm proposals' on a levy could be put out for consultation.

The DH statement said: ‘The [health] committee received a diverse range of views with regards to the proposal to raise the education and training budget through a levy on providers.

‘This illustrates the complexity associated with the proposal and the need for detailed work.'

In its 2010 white paper Equity and excellence – liberating the NHS the Government stated that in future ‘all providers of healthcare services' would be required to pay the levy that will replace the Multi Professional Education and Training budget that is currently paid to SHAs.

It said this would ‘support the level playing field between providers', but the plans led to concern from GP leaders.

Earlier this year in written evidence to MPs, the RCGP warned the levy could have a drastic impact on GP practices.

It said: ‘Such a system could have significant unintended consequences for small providers, including GP practices, who have previously not been required to pay for training.

‘Such payments could cause an exodus of senior staff, destabilising the system as a whole.'

Dr Laurence Buckman, GPC chair, said he was ‘pleased' the Government was reconsidering funding for medical training.

He said: ‘GPs should not be charged for the privilege of training the next generation out of personal or practice income. We will await the outcome of their deliberations with interest.'

Dr Beth McCarron-Nash, a GP in St Columb Major, Cornwall, and former GPC negotiator with responsibility for training, said GP practices could not be treated the same as large hospital trusts.

She said: ‘We are small businesses and it is different from being a very powerful provider – such as a foundation trust. The costs in general practice are extremely different.'

A DH spokesperson told Pulse it was still working on the detailed planning, and refused to say whether any levy would still apply to GP practices.


How levy row has developed:

Jul 2010:  Government says ‘all providers of healthcare services' will pay a levy to meet costs of education and training

Dec 2010:  DH consultation paper says implementation of the levy would be ‘staged' with a notional levy preceding an actual one

Jan 2012:  In its policy paper From design to delivery, the DH notes there were concerns about ‘potential side-effects' from levy

Early 2012: RCGP warns MPs levy could have ‘significant unintended consequences' for general practice

May 2012:  Commons health committee report says there is ‘slender evidence of progress' in making levy something that will work in practice

Sep 2012:  DH signals rethink on who will have to pay levy and says work ‘is ongoing'