21 March 2003
The British Medical Association and the NHS Confederation have been forced to revisit the funding formula for GP practices in the proposed new contract amid fears that family doctors could reject the deal.
The BMA has postponed its ballot of GPs, which was due this week. Practices were given an indication of their likely funding levels for next year last week. This prompted complaints that many would no longer be financially viable, even if they won increased payments for meeting high quality standards.
The postponement means a further delay for a key element of the government's NHS reforms, and comes when hospital consultants are in open revolt over the health secretary's attempts to change the basis on which they are paid.
Consultants in England and Wales rejected a proposed contract last year and the Department of Health has since announced that doctors can choose between a number of systems, including the rejected contract and incentive payments.
The BMA wants the department to reopen talks on a new consultant contract. It said up to a quarter of the consultant workforce (7,000 doctors) would retire or resign rather than accept the government's offer.
GP leaders held at least three sessions with the confederation's chief negotiator, Mike Farrar, last weekend, and further talks are planned as they attempt to resolve the problem.
It is unclear whether the family doctors' alarm springs from the fact that they would each lose an estimated £6,000 a year by giving up out-of-hours care, as they would be entitled to do under the new contract.
The BMA GPs' leader John Chisholm said investigations into the cause of the problem would centre on the formula used in calculating practice allocations and the patient list data on which it is based.
'We cannot support funding arrangements that threaten to undermine the viability of practices. At a time of huge GP shortages the last thing we can afford to do is lose practices. We fully understand GPs' concerns and anxieties,' he added.
Farrar added that the delay would not lead to a fundamental renegotiation of the contract and would be concluded as soon as possible.
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