The Minster Practice, Lichfield
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On 14th May 2003, Dr Michael Causer attended a special conference of LMC (local medical committee) representatives called to discuss the proposed new contract for General Medical Services (GP contract for services). The contents of the contract were broadly acceptable as leading to improved patient care which is as important to GPs as take home pay. The quality of our working life is improved tremendously when we can fund quality healthcare. However, the planned redistribution of funds around the country coupled with the fact that we would fully fund our staff costs from our own income threatened the financial viability of many practices. The formula used to calculate the redistribution has not been published and tested. As 75% of GPs are losers under this formula, the formula is under serious question. The situation is made worse by the application of the formula to practice list sizes calculated from census data rather the actual number of patients registered with doctors: census population is 6% less than the number of people registered with GPs. However, the Government eventually accepted that the census data should not be used for the time being. The Government also offered a longer term Minimum Practice Income Guarantee (MPIG) to minimise the impact of the formula. The MPIG has been funded by reducing quality service payments. This is a sticking plaster on a serious wound to the basis of the contract and whether it will be enough to get a YES vote in the ballot of GPs remains to be seen. The ballot took place between 2nd June and 20th June 2003.
On the eve of the ballot, the Chairman of the British Medical Association's General Practitioners Committee stated that "I believe that this contract now represents the best future for general practice. Acceptance and implementation of the contract truly have the potential to regenerate general practice and at last produce improvements in morale, recruitment and retention. You asked for a new contract that was better for doctors and better for patients. I believe this contract delivers that...... It meets the objectives laid down by the profession in the National Survey of GP opinion in 2001, and it will deliver high quality care for patients."
Local GPs met on 9th June to discuss the latest version of the new contract with members of the South Staffordshire Local Medical Committee; a body that represents the interests of local GPs and local health services.
The ballot result was as follows: 79.4% of valid vote YES Turnout 70%; YES vote represents 56% of GPs and GPs in training eligible to vote
Main improvements flowing with the new contract Whilst GPs income will generally rise substantially, this has been tied to change in practices to benefit patients and basing income on the quality of service. Primary care services will benefit from a 33% increase in resources between 2003 and 2006. The other main changes are:
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