Published: 27/03/2003, Volume II3, No. 5848 Page 8 9
The British Medical Association's GP committee will meet today to discuss the introduction of an income guarantee for the new GP contract.
The BMA and the NHS Confederation have agreed in principle to guarantee doctors that they will not lose out under the formula used to calculate practice income.
The meeting today comes amid threats of industrial action by some inner city GPs who fear bankruptcy if they accept the existing deal. Some say they will stop taking new patients, or even resign from the NHS, if they do not get changes to the current contract, which they say would see 70 per cent of practices face an income cut of about 20 per cent.
But Mike Farrar, who is leading negotiations for the NHS Confederation, said fears that doctors could lose out under the new deal were rooted in weaknesses in the data used to make calculations, not the formula itself.
Describing the architect of the formula, statistician Professor Roy Carr-Hill from York University, as a 'world leader in the field', Mr Farrar insisted his formula had taken account of inner city workload and demographics.
'The formula has age, sex and long-term sickness which will pick up a lot of the workload concerns.'But he said the formula was only as good as the data on which it was based.
'The better the data gets, the fairer the allocation will be. The new contract was designed to iron out enormous inequalities and mean a redistribution that will benefit all GPs - even in over-doctored areas where they lose a GP they would not lose income, which is what happens at the moment.'
Both Mr Farrar and the BMA's GP committee have apologised for shortcomings in the way the contract was presented and in using census data from the Office of National Statistics. And a spokeswoman for the committee said the Carr-Hill formula should have been more widely piloted at primary care trust and practice levels.
Dr Clare Highton, co-chair of the professional executive committee of City and Hackney PCT, said GPs in her trust faced a 23 per cent income cut under the new contract. She said the Carr-Hill formula did not take account of the higher workload and greater patient turnover of inner city GPs.
In a letter to Mr Farrar and GPC chair Dr John Chisholm, City and Hackney PCT warns: 'There is a growing sense that inner city general practice may be destroyed, perhaps because the government sees the future as personal medical services or privatisation. This would be a catastrophe for us, our staff and above all our patients, who still want to see a doctor they know and trust'.
The PCT was due to meet yesterday to discuss possible action in the event that its concerns are not acknowledged.
But Mr Farrar promised that GPs in City and Hackney would not face a cut in income. 'I am confident that we can resolve the problems, and GPs in Hackney will be reassured that they do not face a cut. This contract was all about ensuring a 33 per cent increase in income and resources.'
The contract package also allows GPs to opt out of providing out-of-hours cover. But without a quick end to the funding row, a parliamentary slot for legislation enabling PCTs to take over out-of-hours commitments could be missed.