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New GPC chair warns ministers over plans to change GP contract



Ministers must recognise the ‘folly of getting into a battle’ with GPs and instead adopt a much more consensual negotiating strategy as contract talks over out-of-hours responsibility loom, the new chair of the GPC has urged.

In an exclusive interview with Pulse, Dr Chaand Nagpaul – who was elected to replace Dr Laurence Buckman as GPC chair yesterday – warned the Government that its plans to change the GP contract in a bid to improve out-of-hours care would do little to improve services.

He claimed that this year’s contract imposition had ‘exhausted’ GPs and failed to improve patient care, and said: ‘I would like to believe that the Government has learned that it doesn’t help to be in conflict with GPs.’

Dr Nagpaul, who joined the GPC in 1996 and has been lead negotiator for commissioning and on IT and enhanced services, was elected for a three-year term as chair.

He defeated GPC deputy chair Dr Vautrey, negotiator Dr Dean Marshall and a joint bid from Drs Fay Wilson and Michelle Drage.

Asked in his first interview since taking over how the GPC’s negotiating strategy was likely to change, he said: ‘I think it is more a case that the Government, I hope, will change its approach.’

His first challenge is likely to be the forthcoming round of contract negotiations for 2014-15, with NHS England having confirmed that it will take forward health secretary Jeremy Hunt’s call for a change to the GP contract to hand back accountability for out-of-hours care to general practice.

But Dr Nagpaul said: ‘I think what the Government should be more interested in should be improving the delivery of out of hours services for patients – and you don’t need to make it a contractual responsibility to deliver that.’

‘You can’t divorce GP out of hours services from 111, from walk-in centres, unscheduled work settings such as Darzi clinics and minor injury units. We think that there is no need to be focusing on the GP contract. What we should be focusing on is enabling GPs to commission effective out of hours services.’

Dr Nagpaul refused to be drawn on whether any new GP contract would be to a ballot of the profession, although he said ‘my position is one of working in a GP democracy.’ But he said it was essential that next year’s deal was the result of negotiation rather than another imposition.

‘I think there is ample evidence that the imposition, forced contract change, has made GPs work beyond capacity and has not improved patient services,’ he said. ‘It is making GPs exhausted and it cannot have helped the Government. So I hope and believe that the Government has recognised the folly of one-sided contract change and I would like to believe that I will be able to articulate to the Government the benefit of supporting us as a solution to the pressures on the NHS, not some sort of obstacle to overcome.”

He added: ‘I would like to stand up for what is right for general practice, what is right for patients and right for GPs. But I am really hoping that the Government will see the folly of getting into battle with us when the most important thing for Government is to actually work with GPs.’

Dr Peter Holden and Dr Richard Vautrey have been re-elected to the negotiating team alongside Dr Beth McCarron-Nash, who lost her place last year but will now be reinstated in the role. The final UK-wide negotiator Dr Dean Marshall was not up for election as he began a three-year term last year.

Also part of the GPC negotiating team are Northern Irish GPC chair Dr Tom Black, Scottish GPC chair Dr Alan McDevitt and newly-elected Wales GPC chair Dr Charlotte Jones.

Chair-elect of the RCGP Dr Maureen Baker said on the social networking site Twitter she was ‘delighted’ to be working with Dr Nagpaul.

She said: ‘Many congratulations on election. Delighted will be working with you in promoting general practice and GPs for patient benefit.’

NHS Employers chief executive Dean Royles said: ‘This is an important appointment. We look forward to working with [the GPC] in what will be a critical period for primary care. As the GP contract now operates differently in each of the four UK countries, we will need to quickly establish an approach that recognises the differing ambitions across the four countries for the GMS contract.’