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Revealed: How GPs narrowly avoided access targets in new GP contract



Exclusive The GPC countered attempts by the Government to include out-of-hours responsibility and longer opening hours in the GP contract, according to the GPC chair.

Speaking in an exclusive interview with Pulse, GPC chair Dr Chaand Nagpaul said negotiations in a ‘pre-election’ year were particularly tough with the Government wanting to add ‘a huge amount’ to the contract.

Asked whether the contract would help to relieve pressures on GP practices in the short term, Dr Nagpaul admitted that the ‘overall pressure’ may not change much but said that the success of the negotiations should also take into account ‘what is not in it’.

The agreement, announced this month, will see few changes to the contract, with the most notable points including a rolling over on the avoiding unplanned admissions DES, a named GP for every patient, increased funding for maternity and paternity cover and practices publishing their average earnings.

But it comes at a time when the Government is emphasising its commitment to increasing access to primary care, which includes a promise by Prime Minister David Cameron that all patients will have seven-day access to GP services by 2020.

Dr Nagpaul told Pulse that getting the Government to agree to only small changes was a tough negotiation. He said: ‘What is also important to recognise is that in a pre-election year there was a huge amount that the Government wanted to add to the contract, and we managed to push back on most of that. So what we have is a contract that should be judged as much by what is not in it as what is in it.

‘I can assure you that there is no way that this contract that we got reflects the wish of Government. We negotiated very hard to make sure that we did not agree to elements that would have added further workload, and more misery, for GPs.’

When asked what the Government had pushed to include in next year’s deal, Dr Nagpaul said that the fact GPs are not taking on extended contractual hours or out-of-hours responsibility ‘speaks for itself’ in light of the Government’s agenda for increased access.

He added: ‘The fact that we are here today with a contract with hours of availability that have not changed I think speaks for itself. I am not responsible for out of hours, those arrangements have not changed. We know the Government has a strong agenda for access – none of that is in the contract. We have actually managed to stem many elements of what the Government would have liked.’

Asked how the GPC was able to refuse the Government, Dr Nagpaul added: ‘I was very straight with the Government. I asked them to open their eyes and look at the facts in front of them. We have a situation where the Government’s own commissioned studies are talking about a workforce crisis. We have seen a 15% drop in young graduates choosing general practice as a career. We are seeing practices closing, younger doctors emigrating, leaving.

‘All I did was tell the Government: “look at this picture in front of you, and you have a choice of action – of making this worse and seeing the whole of general practice collapse, or you have a choice to stand back and limit changes to the contract, get rid of some of the headaches for GPs”.’

However, local GP leaders were less optimistic about the deal.

Dr Tracey Vell, honorary secretary of Manchester LMC, said: ‘There is needless bureaucracy in the named GP for all patients which highlights politicians’ ignorance of how GPs work. I would have liked more details on financial support for premises.

‘Pointless enhanced services are still missing the point about avoiding admissions and extending access. The main feeling is “meh” – which is probably better than feeling that it is a disaster.’