Thursday, August 23, 2007
GP contracts
If the coverage on Radio Wales is anything to go by then the Auditor General for Wales, Jeremy Coleman, seems to have put the cat amongst the pigeons this morning with a report on the new GP contract.
He reveals that the NHS was forced to raid other budgets to pay for the new GP contract, which cost 44% more than expected in Wales. He says that the extra costs amount to tens of millions of pounds and that as a result local health boards were drained of money that should have been used to develop community services in the first few years of the contract. In the meantime GP salaries have rocketed by 25% over four years, as the contract introduced performance-related pay but reduced workloads.
He says that if the contract is to deliver value for money then “The barrier for the points system [which measures GP performance and distributes funding] needs to be raised to make sure that the benefits for patients are real and continue to follow.”
The BMA seems to have taken this personally, but in my view there is no need for them to have done so. I do not believe that the value of GPs are disputed nor is there any disagreement with the premise that they should be adequately remunerated and have reasonable conditions of work. As Mr. Coleman points out there is evidence that patients have better access to GPs, and some chronic disease management services are now more readily available. The contract has also helped to arrest the GP recruitment and retention crisis in Wales, making the profession more attractive to young doctors – the 2006 GP vacancy rate was 1.8%, compared to 2.1% a year earlier.
There have been benefits to patients from the contract but the thrust of the report is that better management by Local Health Boards combined with the diversion of more resources into Primary Health Care and community services can deliver much more. That will benefit everybody, including GPs and should be a priority of the Welsh Assembly Government.
This report shows the value of the Auditor General's office in driving forward public service improvement and ensuring that taxpayers get value for money. As such it should be welcomed, whatever the sensitivities involved.
He reveals that the NHS was forced to raid other budgets to pay for the new GP contract, which cost 44% more than expected in Wales. He says that the extra costs amount to tens of millions of pounds and that as a result local health boards were drained of money that should have been used to develop community services in the first few years of the contract. In the meantime GP salaries have rocketed by 25% over four years, as the contract introduced performance-related pay but reduced workloads.
He says that if the contract is to deliver value for money then “The barrier for the points system [which measures GP performance and distributes funding] needs to be raised to make sure that the benefits for patients are real and continue to follow.”
The BMA seems to have taken this personally, but in my view there is no need for them to have done so. I do not believe that the value of GPs are disputed nor is there any disagreement with the premise that they should be adequately remunerated and have reasonable conditions of work. As Mr. Coleman points out there is evidence that patients have better access to GPs, and some chronic disease management services are now more readily available. The contract has also helped to arrest the GP recruitment and retention crisis in Wales, making the profession more attractive to young doctors – the 2006 GP vacancy rate was 1.8%, compared to 2.1% a year earlier.
There have been benefits to patients from the contract but the thrust of the report is that better management by Local Health Boards combined with the diversion of more resources into Primary Health Care and community services can deliver much more. That will benefit everybody, including GPs and should be a priority of the Welsh Assembly Government.
This report shows the value of the Auditor General's office in driving forward public service improvement and ensuring that taxpayers get value for money. As such it should be welcomed, whatever the sensitivities involved.
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Far from taking the Auditor General's report into the GMS contract personally, the BMA's concern stems from the misleading and totally inaccurate 44% figure.
The claim that the new contract "cost 44% more than expected" is inaccurate. The 44% mentioned in the report is in the context of an intended uplift of 38%, so is 6% more than intended, mostly accounted for by the increased performance achieved by GPs in Wales in increasing the quality of service to patients.
This delivery of evidence based improved care to the people of Wales should be celebrated.
In the report, an overspend of only 2% is recorded for 2005/06 over the intended budget.
The "overspend" on the nGMS contract has occurred in all four countries of the UK. What should be publicised is that Wales has made the smallest overspend, despite our heavy burden of chronic disease.
John Jenkins
Public Affairs Officer
BMA Cymru Wales
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The claim that the new contract "cost 44% more than expected" is inaccurate. The 44% mentioned in the report is in the context of an intended uplift of 38%, so is 6% more than intended, mostly accounted for by the increased performance achieved by GPs in Wales in increasing the quality of service to patients.
This delivery of evidence based improved care to the people of Wales should be celebrated.
In the report, an overspend of only 2% is recorded for 2005/06 over the intended budget.
The "overspend" on the nGMS contract has occurred in all four countries of the UK. What should be publicised is that Wales has made the smallest overspend, despite our heavy burden of chronic disease.
John Jenkins
Public Affairs Officer
BMA Cymru Wales
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: 3:10 PM
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