Funding boosted in new deal for GPs

General practice is to get a 33-per-cent boost in funding under radical reforms proposed in a new contract for doctors unveiled today.

The new General Medical Services (GMS) contract for the the UK's 36,000 family doctors will bring about the biggest changes in general practice for more than 40 years.

The deal, which will see spending on general practice rise from £6.1 billion per year to £8 billion by April 2006, is designed to tackle the growing shortage of GPs.

It is not yet clear how much extra pay individual doctors will get under the new deal, but their incomes should rise substantially.

It has been predicted that some top earners could get more than £80,000 under the new deal, compared with current average earnings of £61,000.

Ministers will hope the deal stops GPs leaving the profession and encourages more, newly–qualified doctors to consider it as a career.

In January this year the British Medical Association (BMA) released figures showing that vacancy rates among GPs had worsened.

Dr John Chisholm, chairman of the BMA's General Practitioners' Committee, warned that general practice was "approaching meltdown".

In the UK there are currently 36,000 GP "principals", who are self–employed independent doctors, divided between 11,000 practices.

Another 7,000 work as locums, assistants and salaried doctors.

The Government promised that GP numbers would rise by 2,000 by 2004, but by the end of last year the equivalent of only 386 full–time posts had been filled.

Around three–quarters of GPs have a GMS contract, while the remainder have a locally negotiated Personal Medical Services contract.

Doctors' leaders and the NHS Confederation have spent the last 18 months negotiating the new contract.

Every family doctor in the UK will be asked to vote on the deal next month and, if accepted, it could start to be implemented later this year.

There are no guarantees they will accept it.

In October last year hospital consultants in England voted by two to one to reject a proposed new NHS contract.

Health Minister Lord Hunt said: "This needs to be judged in terms of 'will it bring better services for patients?' I believe it will." "At the end of the day it will provide a more accessible and more flexible health service.

"I am convinced that patients will be the winners here," he told BBC Radio 4's Today programme.

Dr Michael Dixon, a GP who chairs the NHS Alliance, said doctors would welcome the "wonderful investment in primary care", adding that it would help ease a major shortage of family doctors.

Patients' Association chairman Mike Stone said anything which could stop the "mass exodus" of GPs was welcome, but added that he hoped the out–of–hours service would not disappear.

The NHS Alliance welcomed the new GP contracts, saying it represented "a considerable improvement on the original draft".

Chairman Dr Michael Dixon described the contract was "a turning point for primary care".

He said: "It isn't just about GPs and income, it is about shifting investment to the front line – where it should have been all along.

"At last we are seeing more than lip service to the principle of a primary care led NHS," he said.

Dr Dixon said there were still issues that needed to be addressed, such as development for practice managers and dispensing.

But he added: "For the time being though, this proposed contract offers the best chance in years of restoring general practice as the 'jewel in the crown' of the NHS

"It promises a vision of modernised general practice, where personal care still matters.

"We must wait to see if GPs will sign up to this vision but the NHS Alliance, as an advocate of clinicians as well as patients and PCTs, will be strongly encouraging them to do so."

Dr John Chisholm, chairman of the British Medical Association's general practitioners committee, said some GPs who offered all the extra services and offered high quality patient care could see their pay rise by 50% over the next three years.

Others, however, who offered fewer services might see only a 10% increase in pay under the new deal.

He said: "We have had a desperate problem with recruitment and retention and one of the answers – but not the only answer – is money and investment."

He stressed that as the extra funding was allocated to general practices rather than directly to doctors, it was impossible to predict an average income under the new contract.

Currently GPs typically earn around £61,000 a year.

Dr Chisholm said the deal should be better for patients as well as for doctors.

"This is an historic step change in the level of funding for general practice," he said.

"In health services as a whole we have faced problems for years and years of chronic under–funding."

He said too often extra resources had gone to hospitals.

"This time it is primary care's turn, it is general practice's turn," he said.

The contract would help halt the tide of doctors leaving the profession and by attracting more new recruits, patients would find it easier to see a GP, he added.

At the moment there are more than 1,000 unfilled GP vacancies and many existing family doctors are planning to retire.