01 April 2004
Doctors' leaders have warned that the government's determination to make public services competitive may undermine general practice and is tantamount to a trade in patients.
Late amendments to the new GP contract, to be introduced on April 1, will partially lift the 56-year-old ban on the sale of 'goodwill' in the NHS. This allows alternative providers to bid for the expected profitability of a service over and above tangible assets, such as premises and equipment.
The British Medical Association believes the sale of goodwill would favour commercial competitors, who would take over contracts for additional and enhanced services such as cervical screening and immunisation.
John Chisholm, chair of the BMA's GP committee, said the decision would have 'far-reaching and fundamental effects' on the way general practice is delivered. 'I don't think it will benefit patients and it certainly won't help general practice recruitment. It will drive costs up and has the potential to severely damage the most cost-effective part of the NHS,' he said.
Although the BMA agrees that alternative providers have a place in the health service, Chisholm said they did not need the added encouragement of being able to trade in goodwill. Doctors are also concerned that the move could drive up the cost of buying into a general practice and so deter young doctors from choosing a career in primary care.
Chisholm said it was unlikely that the government could be persuaded to change its minds. 'Our assumption is that the regulations are going to go forward because the government is determined they will,' he added.
'The government is saying it will review the situation, but it can be difficult to put the genie back in the bottle a couple of years down the road.'
A Department of Health spokesman said the sale of goodwill would have only a minimal impact, affecting only 6% of GP services. 'It will not impact on the cost of entry into core primary care provision nor will patient care suffer as a result of these changes,' he said.