By Ian Quinn
Exclusive: The Liberal Democrats have called for a new postcode-based funding system that would see GPs paid more for working in practices treating patients from the most deprived areas.
GPs could also receive a funding boost if they were prepared to opt back in to providing out-of-hours care, with the party’s manifesto calling for their ‘direct involvement’ in covering on-call services.
The party’s health spokesman, Norman Lamb, followed his counterparts for Labour and the Conservatives in talking exclusively to Pulse last week.
He said Government’s moves to increase the number of GP practices in the poorest areas had gone nowhere near far enough in tackling health inequalities and that there needed to be a radical overhaul of GP funding.
He also claimed it was a ‘dereliction of responsibility’ for GPs not to be involved in out-of-hours care, and said Conservative plans to give GPs power over commissioning services did not go far enough.
Mr Lamb said: ‘We’re open in terms of how’s its implemented, but the principle that you want to incentivise GPs to take more people from disadvantaged communities must surely be a sound one.’
He said the Liberal Democrats supported the findings of a report by the Policy Exchange think tank, which calls for premiums to be paid for GPs in a bid to encourage them to work in areas with high deprivation.
Under its proposals, practices would be paid according to the age and postcode of their patients, broken down to as small an area as 15 homes.
Mr Lamb also said there was a ‘critical difference’ between GPs being given commissioning responsibility, as in the Tory plans, and actually taking on the work, as he wanted.
‘The Conservative idea of getting GPs to commissioning out of hours services is flawed,’ he said. ‘You could end up with the same commissioning arrangements as we have now – and who is responsible when things go seriously wrong? It will be the GPs who commission those services that are liable.’
He said he wanted a return to the GP co-operative model that has died out under Labour, while commissioning responsibility would rest with locally elected health boards: ‘GPs need to realistic that they can’t go on with the status quo.’
The Liberal Democrats are also strongly in favour of ditching practices boundaries and ramping up competition among practices, but Mr Lamb said it would be less enthusiastic than either Labour or the Conservatives about an increased role for private providers.
He also attacked the Government for allowing trusts to plan a huge shift in care from secondary care to primary care claiming ‘GPs are not adequately resourced’, adding that it was a scandal that assumptions had been made on the back of a secret report by American consultants McKinsey.
Norman Lamb MP Norman Lamb on
GPs taking back responsibility for out-of-hours care:
‘There is a critical difference between commissioning out-of-hours care and provision – and it’s provision by local GPs that is the objective we should strive to meet.’
Paying GPs a premium for taking on patients from deprived areas:
‘The Government has not gone far enough. Its approach has been simple – to increase the number of GPs practices but without any incentive for GPs to work in more deprived areas.’
Ditching practice boundaries:
‘The old model where GPs were only open during business hours and you could only visit a GP where you lived needs to change. In the 21st century it simply isn’t sustainable.’
Locally elected health boards:
‘It completely changes the dynamics of NHS care’