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Hold CQC to ransom over rising fees, LMC urges GPC

GP leaders are urging the BMA to launch a formal dispute with the Government over the proposed 76% increase to CQC fees.

Derbyshire LMC argues that although GPs cannot legally withhold CQC fees they could pay them to the BMA to hold in an escrow fund to release depending on negotiation over fee levels and regulatory burden on practices.

In a letter to the GPC, LMC treasurer and former GPC negotiatior Dr Peter Holden said that ‘whilst recognising that GPs cannot break the law DLMC believes that GPC/BMA should declare a formal dispute with the Government over these particular matters concerning the CQC’.

The news comes as the Department of Health has been unable to guarantee it will reimburse practices for the 76% hike in CQC registration fees, stating that it is under negotiation.

The GPC has said it expects practices will be reimbursed, after the CQC proposed to increase all GP practice fees by three quarters next year, with the biggest practices having to pay more than £100,000, and the total fee burden reaching almost £40m.

Dr Holden said: ’We recognise that refusal to pay is tantamount to breaking the law. Our belief is that practices should pay the monies into an escrow accunt that DLMC is asking GPC/BMA to set up and co-ordinate.

’The concept is that practices pay the CQC fees [to] be held by GPC/BMA on behalf of the profession and they will be released to the CQC upon satisfactory arrangements being concluded to deal with CQC, their fees and their unwarranted and unreasonable other demands.’

Dr Holden added that although ‘Derbyshire Local Medical Committee does not have a tradition of militancy’ there is now ’an extremely strong feeling that enough is enough’.

Dr Holden, whose letter said it was ‘time to start showing some teeth to the Government’, told Pulse that the suggestion would not amount to industrial action because it was not about withdrawing labour.

He said: ‘What we are saying is we are not refusing to pay. What we are saying is that the money is sitting there but you have to show us why you need it.

‘We want a long and hard discussion as to why you need a 21-fold increase in fees.’

Derbyshire LMC is not the first to suggest the GPC should be taking a more militant approach to Government negotiations.

As revealed by Pulse last month, some LMCs are considering breaking off from the GPC to form a ‘National Association of LMcs’ and developing a ‘Plan B’ for general practice.

This comes as the Northern Irish GPC is currently assessing GP support for a plan to resign from the NHS en masse and charge patients directly for their services.

Meanwhile, the GPC has surveyed English GPs on their willingness to withdraw certain patient services that fall outside of the core contract.

A BMA spokesperson said: ‘GPC has repeatedly called for the ludicrous increases in CQC fees to be reversed and for a wholesale review of the entire inspection regime and the funding drain it inflicts on general practice.

‘Given the huge pressures on GP practices, it is perfectly understandable that GPs and LMCs like Derbyshire are furious at the costs they are incurring at a time when GP services are struggling to deliver services to patients.’

They added that the GPC remains ‘in active discussions’ with the Government ‘to secure additional new funding to fully cover the projected rise next year’.

The hike in CQC fees

Under the proposals, an average-sized GP practice with 5,001-10,000 patients will see their fees increase by almost £2,000, to £4,500.

The Department of Health put £15m into the 2016/17 GP contract to cover rises in fees for GP practices. It previously said it would ‘review’ future years’ costs, although a BMA spokesperson said the GPC is expecting rises to be fully reimbursed.

The CQC has said the proposed fee rises are the second step in its two-year trajectory to cover all of its costs via charges rather than relying on Government grants, as ordered by the Treasury.

Defending the rise, CQC chief executive David Behan said that ‘protecting the public’ comes with a cost.