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Half of PCTs fail to reimburse GP maternity costs in full



By Lilian Anekwe

Exclusive: Almost half of PCTs are failing to pay practices the full recommended contribution for locum cover when women GPs go on maternity leave, a Pulse investigation reveals.

Over the last financial year, 45% of trusts across England paid out less than the contribution to maternity cover set out in the Department of Health’s statement of financial entitlements (SFE) – leaving practices, or female GPs themselves, to make up the shortfall.

Our investigation also reveals a stark postcode lottery in provision of maternity locum cover, with a 10-fold difference in the highest and lowest average spend per maternity claim across the 126 trusts that provided information.

Average spend per GP on maternity leave in 2009/10 ranged from £3,462 in NHS Peterborough – which nevertheless did make the full contribution for the period it was claimed – to £35,640 in NHS Halton and St Helens. The figures also show the impact of the economic crisis, with PCTs cutting average spend per GP by 9% in just a year, from nearly £19,000 in 2008/9 to £17,000 in 2009/10.

Just one trust – NHS Southwark – paid more than the contribution stipulated in the SFE over the 24-week period.

The SFE, though not a legal document, is issued to all PCTs by the DH, and states they should make a maximum payment of £978.91 per week for the first two weeks and £1,500 per week for the remaining 24 weeks a woman is entitled to maternity leave, based on a full-time GP employing a full-time locum. Provisions in Scotland are slightly more generous.

Our figures provide evidence to support anecdotal reports of under-payment that first came to light last October, when the DH published its report on women in medicine.

The report called for the existing discretionary reimbursements to be scrapped and replaced by ‘contractual changes to compensate maternity leave’.

Baroness Deech, author of the report and a fellow of the Royal Society of Medicine, said Pulse’s findings would be ‘enormously helpful’ and would be discussed at the next meeting of the committee intended to drive through the recommendations in October.

She said: ‘It’s accepted that the right amount should be spent on maternity leave, but it coincides with the need for cuts – things may get worse. But the fact that GP consortiums will soon hold the purse strings might be good news because a significant number of GPs are women.’

Dr Rachel McMahon, a GP and member of Cleveland LMC, said: ‘Until we make it compulsory, PCT maternity cover is at risk, because in this climate trusts are getting squeezed.’

Dr Rebecca Mallard-Smith, a GP in Prestwood, Buckinghamshire, said: ‘When I went on maternity leave I had to return after 12 weeks because I could not afford to make up the difference.’

Dr Rebecca Mallard-Smith: had to cut her maternity leave to 12 weeks