BMA team 'stunned by GP contract' as a bit of a laugh
GPs were so stunned by the terms offered to them when negotiating their new contract in 2004 that they thought it was a "bit of a laugh", a doctor has said. Dr Simon Fradd, who was one of British Medical Association's GP negotiators, said they were shocked by the approach taken by the labour government. They could not believe it when GPs were given the chance not to do evening and weekend work for only a 6% pay cut, he said.
While doctors now make less in basic pay - about £55,000 on average - they have been able to top-up their earnings by hitting targets under a performance-related bonus scheme.
Opponents have often criticised the labour government, claiming they mishandled the contract, which is now contributing to NHS deficits.
Earlier this month, Health Secretary Patricia Hewitt admitted she wished the government had capped the profits doctors could take out of the practices because of the soaring sums. Please also see also the abridged Health Direct posting below from last year.
Dr Fradd was part of the negotiating team representing the British Medical Association during the two years of talks between 2001 and 2003, although he is no longer on the BMA's GP committee.
Interviewed for BBC Radio 4's The Investigation, which will be aired on 1 February, Dr Fradd said doctors had never believed the government would be willing to allow them to opt out of out-of-hours care.
And when they did, he was surprised the NHS Confederation negotiating team, acting on behalf of the government, was only asking for a 6% cut in pay.
He added: "We got rid of it for effectively 6% of the value of the contract. It was just stunning. Nobody in my position had ever believed we could pull it off but to get it for 6% was a bit of a laugh."
Since the contract came in, nine out of 10 practices opted out of providing care.
NHS trusts have put alternative arrangements in place, but hospital A&E departments have reported an increase in patients.
In a separate interview, he told the BBC that he still thought the contract offered good value for money for patients as GPs were still taking up a relatively small part of the NHS budget.
"I think the government underestimated how much out-of-hours care was worth, but there are other parts of the contract, such as performance-related pay, which were harder to sell to doctors."
Looking back on the new contract, NHS Confederation chief executive Gill Morgan said she felt there were too many sweeteners in the deal offered to GPs. "I think it is always easy to underestimate how strongly GPs respond to an incentive that gives them money."
Dr Hamish Meldrum, chairman of the British Medical Association and a member of the BMA negotiating team, would not reveal how much the negotiators would have accepted when it came to the opt out although he said it was "not a sticking point".
"There were areas of the package where big concessions were made. We agreed to other providers in general practice and the other one was performance-related pay."
The Investigation, BBC Radio 4, 2000 GMT, 1 February, 2007.
From:
http://news.bbc.co.uk/1/hi/health/6314301.stm
On Dec 18, 06 Health Direct wrote that Labour's mismanagement has led to NHS deficits when mismanagement at all levels of the NHS in England has led to the current multimillion pound deficit, a committee of MPs has found.
The Commons health select committee said existing deficits were made worse by the cost of new staff pay deals and the expense of meeting NHS targets. Last year's NHS deficit was £547m.
The committee said historic deficits, long hidden, were revealed when the government changed the rules so trusts could not underspend their capital budget to subsidise current spending.
But it said the government fuelled the problem by agreeing to new pay deals for doctors and nurses using estimates of the cost which were "hopelessly unrealistic".
In addition, meeting national targets such as the requirement that no patient should wait more than four hours in A&E had been costly.
Changing targets at short notice also placed unnecessary financial costs on trusts, the report said.
It attacked short-term measures being used by the government to address deficits.
And it said raiding staff training budgets was "unacceptable", and warned such cuts were affecting staff morale and could damage the quality of the workforce.
While doctors now make less in basic pay - about £55,000 on average - they have been able to top-up their earnings by hitting targets under a performance-related bonus scheme.
Opponents have often criticised the labour government, claiming they mishandled the contract, which is now contributing to NHS deficits.
Earlier this month, Health Secretary Patricia Hewitt admitted she wished the government had capped the profits doctors could take out of the practices because of the soaring sums. Please also see also the abridged Health Direct posting below from last year.
Dr Fradd was part of the negotiating team representing the British Medical Association during the two years of talks between 2001 and 2003, although he is no longer on the BMA's GP committee.
Interviewed for BBC Radio 4's The Investigation, which will be aired on 1 February, Dr Fradd said doctors had never believed the government would be willing to allow them to opt out of out-of-hours care.
And when they did, he was surprised the NHS Confederation negotiating team, acting on behalf of the government, was only asking for a 6% cut in pay.
He added: "We got rid of it for effectively 6% of the value of the contract. It was just stunning. Nobody in my position had ever believed we could pull it off but to get it for 6% was a bit of a laugh."
Since the contract came in, nine out of 10 practices opted out of providing care.
NHS trusts have put alternative arrangements in place, but hospital A&E departments have reported an increase in patients.
In a separate interview, he told the BBC that he still thought the contract offered good value for money for patients as GPs were still taking up a relatively small part of the NHS budget.
"I think the government underestimated how much out-of-hours care was worth, but there are other parts of the contract, such as performance-related pay, which were harder to sell to doctors."
Looking back on the new contract, NHS Confederation chief executive Gill Morgan said she felt there were too many sweeteners in the deal offered to GPs. "I think it is always easy to underestimate how strongly GPs respond to an incentive that gives them money."
Dr Hamish Meldrum, chairman of the British Medical Association and a member of the BMA negotiating team, would not reveal how much the negotiators would have accepted when it came to the opt out although he said it was "not a sticking point".
"There were areas of the package where big concessions were made. We agreed to other providers in general practice and the other one was performance-related pay."
The Investigation, BBC Radio 4, 2000 GMT, 1 February, 2007.
From:
http://news.bbc.co.uk/1/hi/health/6314301.stm
On Dec 18, 06 Health Direct wrote that Labour's mismanagement has led to NHS deficits when mismanagement at all levels of the NHS in England has led to the current multimillion pound deficit, a committee of MPs has found.
The Commons health select committee said existing deficits were made worse by the cost of new staff pay deals and the expense of meeting NHS targets. Last year's NHS deficit was £547m.
The committee said historic deficits, long hidden, were revealed when the government changed the rules so trusts could not underspend their capital budget to subsidise current spending.
But it said the government fuelled the problem by agreeing to new pay deals for doctors and nurses using estimates of the cost which were "hopelessly unrealistic".
In addition, meeting national targets such as the requirement that no patient should wait more than four hours in A&E had been costly.
Changing targets at short notice also placed unnecessary financial costs on trusts, the report said.
It attacked short-term measures being used by the government to address deficits.
And it said raiding staff training budgets was "unacceptable", and warned such cuts were affecting staff morale and could damage the quality of the workforce.
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