July 4, 2008
Minister Says GPs Curb Patient Choice ; Call for Phone Consultations
By Jane Kirby
GPs are undermining choice in the NHS by operating "gentleman's agreements" not to take on each other's patients, a health minister says.
Ben Bradshaw yesterday outlined plans to reform how GPs are paid, saying the current system dampened the incentive to attract new patients.
But the British Medical Association said Mr Bradshaw's claims were absolute nonsense while the Liberal Democrats called on him to provide evidence.
At present, GP pay is made up of several components, including the "minimum practice income guarantee" (MPIG).
MPIG was agreed to by the Government when a new GP contract came into force in 2004 and offers doctors a guaranteed amount of cash every year. Some 4,500 practices in England receive income protection under this system.
The Government wants to scrap MPIG, saying it acts as a disincentive and means some practices can survive with just a few patients.
Mr Bradshaw said: "There is no doubt there are some areas where gentleman's agreements operate that mitigate against lists being open to new patients and therefore work against real patient choice."
He said Government research had found one practice in the South of England with just two patients, but he refused to say where that was. Nor could he say how widespread the issues were.
GPs receive an average of pounds 100 for each patient on their list, but get only pounds 50 on average for accepting a new patient.
Mr Bradshaw said later: "GPs currently get about twice as much for an existing patient as they do for a new patient. We want a system that fairly rewards GPs and I think that would be the most significant contribution we could make to patient choice."
But chairman of the BMA's GPs committee Laurence Buckman said: "It is absolute nonsense to suggest there are gentleman's agreements - it just doesn't happen. Nor are we going to compete for patients. That is not the way general practice works."
A Department of Health spokeswoman said it was committed to fairer funding.
Mr Bradshaw, who has angered GPs over extended opening and polyclinics, spoke as the Government published its strategy for primary and community care.
It calls for more email and telephone consultations between GPs and patients and a larger focus on prevention.
Liberal Democrat health spokesman Norman Lamb said of Mr Bradshaw: "Ratcheting up his war of words with the BMA in this way demonstrates the complete breakdown in trust between the Government and those on the health service's front line.
"If Ben Bradshaw is going to make provocative and inflammatory statements about GPs' behaviour, he must back them up with facts.
Shadow health minister Mark Sim-monds said Labour was dithering over giving people the right to choose a GP.
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