GPs to get rises of 10-50% over three years

Britain's GPs could be in line for a 50% pay hike if they accept a new contract hammered out between the BMA and the NHS Confederation last week.

The contract—the result of 16 months' wrangling that saw the Department of Health hand negotiations over to managers after the talks reached a stalemate—will see a 33% rise in investment in primary care over the next three years.

Under the contract, which applies throughout the United Kingdom, spending on general practice will rise from £6.1bn ($9.6bn; €9bn) a year to £8bn a year by April 2006.

Family doctors can go for one of three options. They can provide essential services, additional services, or enhanced services. Those who choose the latter will be able to pick up the greatest rewards, and could see an extra 10-50% in their pay packets, said John Chisholm, chairman of the BMA's General Practitioners Committee.

Essential services are “bread and butter” services undertaken by all GPs. Additional services will include childhood vaccinations and cervical screening. Enhanced services will cover areas such as minor surgery or improving access to patients.

And for a penalty of £6000 GPs will be able to opt out of out-of-hours care.

For the first time, money will follow patients, rather than GPs, so if a practice loses a partner, the practice will keep its money and will be able to cover the gap with a salaried GP or nurse.

Dr Chisholm added: “If a practice is under particular workload strain it will forgo some of the additional services. The move from a doctor based system to a ‘patient needs’ led system is going to create considerable redistribution within available resources.”

He said that any losers under the new deal would be GPs who were not providing good quality services at the moment. The negotiators, who were in talks around the clock, believe the contract will go a long way to tackling recruitment and retention problems in GP practices and will attract new recruits.

The BMA is planning a series of roadshows to explain the new contract next month, and on 20 March ballot papers will go out. The ballot will close on 11 April.

At a press conference outlining the plans, Dr Chisholm made it clear that although he and his negotiating team supported the deal, they were not recommending to GPs that they accept it. This was because of the BMA's experience with the contract rejected by consultants last year.

The contract has the blessing of the government. Health minister John Hutton said: “For the first time GPs' pay will depend on the quality of the services they provide. The better they do the more they will get. And the contract proposes that the more NHS work GPs do the higher their rewards will be. This provides a positive incentive for GPs to treat patients in the community rather than referring them to hospital for treatment such as diagnosis or minor operations.” (See p 457.)

Figure.

Dr John Chisholm: The system is going to create “considerable redistribution”