The British Medical Association has condemned the government for putting GPs into an impossible position and forcing them to choose between ‘two bad alternatives’ on GPs’ hours.
The BMA’s GPs Committee (GPC) met on Friday to discuss the two ‘options’ the government has given GPs regarding changes to their contract.
The committee passed the following resolution: ‘The GPC has come to the conclusion that Option A1 is less damaging for general practice, because the alternative option will harm the underlying fabric of NHS general practice and patient care more quickly and more lastingly.’
Commenting on the resolution, Dr Laurence Buckman, chairman of the BMA’s GPs Committee said on Saturday: ‘GPs have been put in an impossible position and will have to choose between two unacceptable alternatives.
‘We have been asked which of these two is less bad and we have responded to GP demand that we do that.
‘We are not recommending any course of action and GPs are free to come to their own decision on how to vote.
‘This is neither a climb down nor a U-turn but a recognition that between two bad alternatives, one is worse than the other.
‘The two deals on the table from the government haven’t been negotiated, they are inflexible and do not take into account the differing needs of populations around the UK.
‘It’s this method of “negotiation” that has angered GPs and it’s why we felt we couldn’t accept anything without first consulting the profession.
‘We still have huge concerns that patients will get neither a meaningful service in extended hours nor will the quality be of a level they deserve.
‘We believe the impositions as they stand will be unsafe for doctors as they will have to work on their own late at night. Patients also won’t get the full range of services.
‘GPs are willing to do extended hours, we put forward our own proposal in December – we just don’t think the government’s plans as they stand at the moment will be good for general practice or patient care.’
The BMA will be polling the entire profession in mid-February.
Option A refers to the government deal put to the GPC on December 20, 2007.
It includes;
• Extended opening for 30 minutes per week per 1,000 registered patients – this would need to be in blocks of 1.5 hours after 6.30pm or for one hour prior to 8.00am or on Saturday morning
• Part of the funding available for access (35p per patient) would be dependent on the results of access questions contained in the QOF (Quality Outcomes Framework) patient survey. This would include targets for 24/48 hours access and booking
If GPs did not agree with Option A, the government said that Option B would be imposed.
Under Option B:
• 135 points permanently removed from QOF including clinical areas such as influenza vaccination and management areas such as computer security. The overall impact would be a QOF with only 865 points instead of the current 1,000.
• All lower QOF thresholds would be uniformly raised to 50 per cent. In general, practices will lose money as the range gets narrower unless they are scoring above the higher threshold for that indicator
• Funding for extended hours would be allocated to PCTs (Primary Care Trusts) for them to agree local contracts for extended opening with any practices – including those newly set up private APMS (Alternative Providers of Medical Services) practices.
The BMA stresses: ‘Experience has shown that it is likely that only a proportion of the funding would end up with any general practices if allocated to PCTs.
