By Ian Quinn
The Government has pledged GP pay will not be dependent upon their commissioning performance and has pushed ahead with plans for consortia to reward practices with controversial incentives for their success in rationing NHS care.
Health minister Simon Burns told the House of Commons that so-called quality premiums paid to consortia would ‘clearly be separate' from GP contracts, despite speculation that up to 15% of practice income may depend on their commissioning record.
‘The quality premium will be funded from existing resources. It will quite clearly be separate from the payments to GP practices for providing primary medical services,' he said.
Speaking in the committee stage of the Health and Social Care Bill, which quashed amendments that could have barred the controversial incentives, Mr Burns said: ‘Some members of the medical profession have expressed concerns about the quality premium, contending that they fear it will come from their current pay and that it will put pressure on them to ration care to patients to ensure that they remain in budget.
‘However, it is not the purpose of the policy to reward GPs for withholding treatment. Instead, what we are proposing is that GP consortia will be rewarded for using their resources to achieve high-quality health outcomes for patients.'
He said quality premiums would be ‘not a bonus, but an incentive' and will improve quality.
‘It enables the NHS Commissioning Board to make payments to GP consortia for their performance. In particular, GP consortia will be rewarded for how successfully they focus their resources to achieve better health outcomes for patients,' he added.
However, GPC deputy chair, Dr Richard Vautrey, said later he feared GPs pay would become directly linked to commissioning, even if it did not come directly from their contracts.
He said: ‘The fact is that the Government has said the quality premium will come from existing resources. If they don't take it from the GP contract the only other way is for them to top slice the entire funding of the NHS, which will reduce GPs income. The reality is they will have to take it from somewhere.'
The GPC claims the Government's plans for nationwide financial incentives for GPs to cut referrals to hospital are 'unethical'.
As the committee stage of the health bill continues, the BMA is also calling for MPs to back amendments to limit the sweeping powers of the new economic regulator Monitor to drive up competition in the NHS in the same way as in privatised industries such as water, gas, and telecommunications.
In a new briefing paper, the BMA claims Monitor will focus more on enforcing competition than on the provision of effective healthcare and this will lead to the closure of existing NHS services.
BMA chair, Dr Hamish Meldrum, said: ‘Whatever your views of the privatisation of other services, it is certainly not the right model for the NHS. At best, providers of care will be distracted from their main responsibility of providing excellent services. At worst, hospitals will close.'GP pay will be kept 'clearly separate' from commissioning performance, vows minister