GPs ‘forced into deal’ to save cash

Mar 6 2008 by Audrey Barton, The Journal

FAMILY doctors in Northumberland last night said they had been forced to accept cuts to services under a new contract with a debt-ridden health trust.

GPs have been fighting plans by Northumberland Care Trust to shave £1.9m in the next financial year from the county’s locally agreed Personal Medical Services contract, which covers 90% of practices.

The cost-cutting measures could signal closure for smaller rural practices and redundancies at larger surgeries.

Now the trust and Northumberland Local Medical Committee have reached an agreement in principle which will see funding for work taken from hospitals into primary care to offset some of the cuts.

Northumberland Local Medical Committee says doctors in the county have now agreed in principle to cut up to 3% in the first year, down from 8%. But that would double in the second year.

An additional £1.4m of funding will pay for more work from hospitals to be done in primary care and doctors believe this may prevent surgeries having to close.

The care trust, which is battling a £14m debt and must save £11.9m to break even, has said that to “mitigate the impact of the reduction in the value of the local agreements” it will “move more services into local practices”.

But doctors feel they have been forced to accept the proposal in the interests of patients as they say the trust has threatened them with a takeover of their services by a private company, should they fail to sign by April 1.

Chair of the personal medical services negotiators Dr Julie Johnston said: “We have spent over 13 months trying to negotiate a better deal for the provision of primary care services by PMS practices, but now find ourselves with no alternative but to accept this proposal.

“It has been made very clear to us throughout this process that third party private providers would and could be brought in if practices failed to reach an agreement on the contract.

“We are very concerned about this possibility as we believe there is an important place for traditional family doctors within all areas of Northumberland and we will work hard to preserve that tradition in the interests of our patients.” Dr Jane Lothian, of Northumberland LMC, said there were still concerns over the long-term impact of the new agreement and that negotiations would focus on details still in dispute before it was signed.

However, she ruled out industrial action.

“Strike action is not an option. We are talking about people’s lives and the livelihoods of staff.”

The concerns are that in year two of the proposal the limit to cuts will be 6%, there has been no guarantee of any inflationary rises in coming years, and practice budgets could be reduced further as a result of national negotiations on access and quality. Dr Johnston said: “Small rural practices and some large urban practices are still anxious about their long-term viability, but remain committed to providing a high quality service for their patient.

“Unfortunately, the redundancies of a number of frontline clinical staff are unavoidable as a result of these funding cuts.”

The PMS practices still fundamentally dispute the financial formula which has been applied as they feel it does not take into account rurality.

The care trust has given an undertaking to review this formula as part of work looking at equity of funding across the region in the next two years. Doctors are calling on patients to make their feelings known on developing services at their practices which would bring in more funding.

The trust and LMC are to meet again today to thrash out the details.

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Impact eased, says trust

NORTHUMBERLAND Care Trust said the new deal and the £1.4m meant no practice would have a funding cut in 2008/09 of more than 3% and this figure was less when inflation was taken into account. A few practices would receive more funding.

Chief executive of Northumberland Care Trust, Newcastle and North Tyneside Primary Care Trusts Chris Reed said: “These have been very difficult and complex discussions. We have said throughout that we were working hard to maintain existing services and avoid practice closures. We hope that people will now be reassured that both of these aims have been achieved.

“We have given the concerns raised careful consideration and have taken steps to mitigate the impact of the reduction in the value of the local agreements and in doing so are moving more services into local practices. This involves transferring funding of £1.4m from hospitals to GP surgeries to provide more care closer to home for patients.”

He said: “We acknowledge that these funding discussions have not been popular with the GPs or with many local people, but as a public body we have a responsibility to demonstrate that we are making the best possible use of taxpayers’ money.

“We will continue to work with the GPs to identify other services that could be provided in their surgeries rather than in hospitals. This will increase future investment in primary care and will also lead to benefits for patients…”