By Gareth Iacobucci
Exclusive: GPs are to be denied any formal mechanism for influencing their pay until at least 2013 after the Government dramatically suspended the pay-review process.
The Department of Health told Pulse it would not be asking the Doctors' and Dentists' Review Body to make recommendations on GP pay for the next two years, in response to the Treasury's decision to freeze public-sector pay.
The move will leave the GPC powerless to argue for sufficient uplift at least to cover expenses, or to help take practices off the MPIG, and will mean there is no independent assessment of what GPs should earn.
It thrusts GP negotiators onto a collision course with the DH, with GPC chair Dr Laurence Buckman telling Pulse the committee also planned to oppose several key elements of health secretary Andrew Lansley's GP commissioning plans.
In an exclusive interview, Dr Buckman strongly attacked the Government's decision to suspend the GP pay-review process, in which the GPC and NHS Employers normally submit evidence to the pay review body, which in turn makes a recommendation to the DH.
He said: ‘They've taken away the remit of the DDRB. We think that's quite wrong. The DDRB should have offered us due process and we should know what it thinks we're worth. The Government has said there will be efficiencies. I'm not sure how you can impose efficiencies on tiny businesses, where GPs will bear the brunt of those policies.'
The DH said plans for a pay freeze meant ‘it will not be necessary for the DDRB to make any recommendation', with the Office of Manpower Economics, which runs the DDRB, saying the review body would take information from the GPC for ‘monitoring purposes' only.
The DH will retain the option to take into account practice expenses and efficiencies in awarding a pay deal, but the GPC must now make its case directly to NHS Employers during negotiations with independent arbitration. The devolved governments in Scotland, Wales and Northern Ireland are yet to decide whether to follow the same course of action.
The tension over the pay deal comes as figures reveal GP training applications have fallen by nearly 40% in the last two years, suggesting the profession is becoming less attractive. It is set to be compounded by GP leaders' increasingly vocal opposition to key strands of the Government's white paper – including plans to write commissioning into the GP contract.
Dr Buckman said: ‘We don't think the contract is the place to put commissioning.'
He insisted GPs would need extra pay to cover the cost of their new responsibilities, but that the extra cash should not come as incentives for keeping within budget or reducing ‘inappropriate hospital activity'.
But Dr Buckman also admitted GP consortia may have to accept taking on some PCT debts when they assume commissioning powers, although he said these should not include propping up unpopular Darzi centres and PFI schemes: ‘There's debt that occurs as a result of managing patients. If it did transfer we'd have to manage it.'
Watch the video below to hear Dr Buckman's reaction to the Government's decision to suspend the role of the DDRB. This is an excerpt from a full-length interview with Dr Buckman, which can be viewed here.Health secretary Andrew Lansley and GPC chair Dr Laurence Buckman: pay squeeze raises stakes for talks on commissioning Health secretary Andrew Lansley and GPC chair Dr Laurence Buckman: pay squeeze raises stakes for talks on commissioning Dr Buckman on the DDRB