29 February 2008
The new GPs' contract introduced in 2004 has cost £1.76bn more than the Department of Health planned and led to GP partners' income soaring by 58% over three years.
Under the new contract – negotiated by the NHS Confederation on behalf of the DoH, and the British Medical Association – primary care trusts commission services from more than 8,300 GP practices, rather than contract with individual GPs.
But a National Audit Office report, published on February 28, says GP productivity fell by an average of 2.5% a year for the first two years of the deal, while GPs now work on average seven hours less a week than in 1992.
Pay for GP partners had risen 58% from £72,011 in 2002/03 to £113,614 in 2005/06, but the report notes that practice nurses and salaried GPs 'have not benefited to the same extent'.
NAO director of health Karen Taylor said the new contract was beginning to deliver some of the intended benefits, 'but a lot slower than intended and in some areas not at all'.
She added that GP recruitment and retention had improved, with numbers growing by 4,000, but PCTs had 'largely failed to use the levers' incorporated into the contract to improve access to GP services.
There were more consultations with patients, but not in proportion with the rising costs of the contract, the NAO found. The number of consultations carried out by GPs had actually fallen, with the increase accounted for by a rise in consultations carried out by nurses.
Auditor general Tim Burr said: 'In return for higher pay, we have yet to see real increases in productivity.'
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