A government plan to reward GPs financially if they perform well could be considered “disgracefully unethical”, a doctors’ leader has said.

Laurence Buckman, chairman of the British Medical Association’s general practitioners committee, said he was unwilling to accept a deal where he saved cash for the health service - and potentially denied patients treatment - in order to receive more pay.

Under the reforms, the government wants some of a general practice’s income to be linked to outcomes achieved by groups of GPs.

How much they get is being discussed by the government, BMA negotiators and the profession.

The government is proposing that the “quality premium” be paid to each consortium of GPs, which would then decide how to award it to its practices.

But Dr Buckman told BBC Radio 4’s File on 4 programme the quality premium could be considered “disgracefully unethical”.

In an interview to be broadcast tonight, Dr Buckman said it was unclear exactly where the money would come from, and whether it would be linked to saving the NHS money.

“We don’t understand what the quality premium means,” he told the programme. “We don’t understand where it will come from; we rather fear it will come out of our pay and be paid back to us if we do certain things.

“It appears what we might actually be asked to do is to save money and if we save a certain amount of money we will receive some of our pay given back to us.

“That is something that is appallingly unethical.”

Asked to expand on what he meant by unethical, Dr Buckman said: “Because I don’t believe that I should be saying to a patient ‘you can’t have treatment because that way I’ll get paid’.”

Health minister Paul Burstow defended the scheme.

He told the programme that Dr Buckman’s view was a “gross distortion” of what the government is trying to do.

“What GP commissioning consortia will be rewarded for is improving the survival rates, improving the quality of care that is being delivered to their patients,” he said.

Mr Burstow said funding for the quality premium payments would come from within existing NHS budgets.

However, he also commented this was not about incentivising cuts.

“The Quality Innovation Productivity and Prevention programme which is running alongside these reforms is completely separate from the quality premium and to try to suggest that they are one and the same is really wrong.”

 

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