NEWSLETTER 

Special New Contract Edition

May 2002


YOUR VOTE IS IMPORTANT  

It is make your mind up time. You will shortly be receiving ballot papers for the first vote on the new contract framework. As you know there will be a second ballot after pricing if the first vote is in favour of the proposals. 

Many of you will have already decided how you will vote and some of you will be undecided. The LMC has given a lot of thought to the proposals and has identified some of the issues you may wish to consider before deciding which way to vote. 

Make sure you cast your vote ensuring a high turn out. No matter what the result the message will then be clear to both government and the Negotiating Team as to what the profession thinks. The worst possible result will be a close call on a poor turnout, giving the government an opportunity for creative interpretation of the result thus manipulating the profession into a position of greater weakness. SO CAST YOUR VOTE. 

Having made that point don’t rush your decision. Make sure you are in possession of as much information as possible. There is a Special Conference of LMCs on 20 June where many resolutions will be debated from those of principle opposing or supporting the proposals, to the minutiae of pensions or quality payments. This Conference will be widely reported in the press and may help resolve some of the doubts in your mind. You may wish to see what the profession as a whole is thinking. 

The contract proposals are likely to be as of much interest to PMS GPs as GMS GPs as there will probably be convergence despite the mixed messages coming from the Department and No 10 Downing Street. 

Buckinghamshire and Berkshire LMCs hosted a meeting at Adams Park in Wycombe on 21 May when Laurence Buckman, a GPC Negotiator, presented the Contract Framework to an audience of 250+ GPs. The two county Committees prepared a Briefing Paper for that meeting. 

The excellent presentation, and the subsequent 22 questions, highlighted that the major areas of concern still unresolved are demand management and pensions.

Overleaf are listed the main issues of concern identified by your colleagues and the areas as yet unresolved. The GPC has compiled a list of FAQs, which can be accessed on their website:  

www.bma.org.uk

Our continued thanks to our sponsors, Lloyds TSB and Bayer.

 

The Briefing Paper  

  • Premises section, and ‘loss’ of Saturday mornings/OOH proposals felt to be ‘good’ parts of the Framework. 

Areas Open to Question: 

Matters of Principle 

1         Demand and Workload. What demand management proposals do the new contract proposals contain?

2         Independence.  What affect will the proposals have on GP independence?  Will they remain self-employed?

3         Bureaucracy.  Felt this would reduce for PCOs but not for GPs and could centre on exclusions.

4         Concern expressed that the Government would be able to change the new contract unilaterally. 

The Committees agreed that the following Motions should be submitted to the Special Conference:  

From Berks LMC: 

That Conference firmly believes that General Practitioners cannot make a reasoned judgement on the proposed new contract for GPs without: 

  1. pricing
  2. having sight of other models for providing Primary Care outside traditional NHS contracts produced by the Special Advisory Group to GPC. 

From Bucks LMC: 

  1. That the proposed new contract is more likely to undermine than enhance the Independence of General Practitioners.
  2. That Conference cannot recommend acceptance of the proposed new contract for GPs until all outstanding negotiating issues are satisfactorily completed.
  3. That Conference cannot recommend acceptance of an unpriced contract.
  4. That Conference believes that the proposed new contract will be unnecessarily bureaucratic particularly with regard to identifying and confirming “exclusions”.
  5. That the proposed new contract will enable government unilaterally to add to GP workload.
  6. That Conference advises GPs that if the profession accepts the principles of the new contract they will have to accept what the government is prepared to offer when it comes to pricing. 

The following bullet points are those raised by the Committees and others as a matter of concern: 

  • It will be a weighted capitation based contract creating ‘notional lists – how will the weighted capitation be arrived at?
  • What will happen if there is a ‘No’ vote?
  • Concern the proposal leaves 19 areas still un-negotiated.
  • Importance of the pricing issue highlighted.
  • Highlighted that a ‘yes’ vote in the ballot, followed by a subsequent ‘no’ vote on pricing would be disastrous and would hand the Government a major PR coup. 
  • Felt that, whilst GPs in deprived areas could be ‘winners’ under the proposals, those in more affluent areas could be ‘losers’ and concern this could cause divides within the country and lead to the fragmentation of General Practice.
  • What are the Medico/legal implications for partnership agreements?
  • Felt the proposal would hand all the power to PCOs and that GPs would only be able to have aspiration without the money to control numbers on their list and would have no protection regarding their workload whilst Authorities have the power to allocate patients. 
  • Felt there are several ‘black holes’ in the proposals, e.g. pension arrangements – 11% does not receive dynamising element, and that the more one reads the document the more ‘black holes’ appear.
  • Concern expressed that 24/48-hour access is not listed in the quality payments. 

Garner as much information from as many different sources as possible. The Secretariat will try and answer any questions you may have about the contract document. You must decide whether voting YES will either immediately or in the near future ensure that your terms and conditions of service will be better giving you more control over your working life, or, if by voting NO you have closed the door on improving your lot.  

The answer lies somewhere between those two examples but you must decide which way the balance is tilting.  

Good Luck.
 

 

 

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