The four GP dispensations / jurisdictions. Nothing “national” about GP contracts.

There is nothing “national” about the GP contracts around the UK. The only way to ensure adequate supply is to train enough. NHSreality believes we should aim at overcapacity to ensure both supply and financial control. The contracts seem to endorse “private practice” but at the same time stop GP premises being used at all for private activity. Will this include Insurance and DVLA medicals? We are all in the UK (just) and pay the same taxes, and yet we have dofferential, hidden, randomised post code rationing.

Image result for disunited kingdom cartoon

The BMA in England has produced “A five-year framework for GP contract reform to implement The NHS Long Term Plan” but this does not apply to Scotland N Ireland and Wales, and indeed, it has not been agreed by NHS England in it’s entirety. Despite the lack of recruitment, loss and early retirement of GPs, the whole edifice is falling like a pack of cards.

Pulse commented on the headlines in January observing that this was the most significant reform since 2004. The comments on line are “looks like the exodus will continue” and “150K lloks like a lot but after tax and pension it’s a much more modest sum.” Another is “Well if you are close to the !%)K limit …. what will happen is GPs will simply stop doing NHS work”.

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In Northern Ireland the HSC (Health and Social Care) Board rules.

In Wales the GPone website from the Welsh Government supplies their details. In Wales agreement has not been reached on the litigation funding arrangements, which at present may be top-sliced obligatorily, and causing resentment. In Wales we even cerebrate a reduction in the degree of bankruptcy…   and the poorest standards in Bowel Cancer screening, results, and Waiting times.

The Scottish Government contract and website is different again

NHS England contract 2019 which all the headlines are about. They ignore the other 3 dispensations. The Medical Indemnity scheme is funded separately in England, and will not be top-sliced as threatened in Wales.

“A new state backed indemnity scheme will start from April 2019 for all general practice staff including out-of-hours.” (NHS England)

See the source image

See the source image

This entry was posted in A Personal View, General Practitioners, Patient representatives, Political Representatives and activists, Post Code Lottery, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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