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Gp Contracts

Volume 404: debated on Tuesday 6 May 2003

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To ask the Secretary of State for Health if he will estimate the average change in income received by a GP's surgery as a result of the proposed GP contract; and if he will make a statement. [109962]

[holding answer 28 April 2003]: The new contract for general medical services negotiated between the General Practitioners Committee of the British Medical Association and the NHS Confederation provides for an unprecedented level of additional investment in primary care services. If the contract is accepted, overall investment in England would rise by 33 per cent. The proposed Minimum Practice Income Guarantee will also mean that no practice loses out, provided it is achieving 100 quality points in 2004–05 and 150 in 2005–06. Most practices will see a substantial rise in gross income. The average increase will depend on what services general practitioner practices provide and the level of quality they achieve.

To ask the Secretary of State for Health (1) if he will make a statement on the impact the Carr Hill Resource Allocation formula will have on the budgets of GP practices; [110001](2) if he will make a statement on the progress made with the implementation of the new contract for GPs; [109999](3) if he will make a statement on the use of nominal lists rather than actual lists for the determination of resources allocated to GP practices. [110000]

[holding answers 28 April 2003]: The new contract for general medical services, negotiated between the NHS Confederation and the general practitioners committee (GPC) of the British Medical Association, was published on 26 February. Following the distribution, by the BMA in mid-March, of details of individual practice weighted populations, the GPC announced that it was postponing the ballot of its members on the contract so that concerns being raised about funding arrangements could be addressed.The new allocation formula, adopted by the negotiators, will distribute resources according to patient needs. It takes account of six determinants of practice workload and circumstances:

Patient gender and age for frequency and length of surgery and home visit contacts
Patient gender and age for nursing and residential home consultations
Morbidity and mortality
Newly registered patients
Unavoidable costs of rurality, to take account of population density and dispersion
Unavoidable higher costs of living through a market forces factor applied to all practice staff.

The negotiators have confirmed, in a letter issued on 17 April, that they remain committed to the principle of redistributing resources according to patient needs as will happen with the new formula. They have also reconsidered how income protection can best be delivered, through a minimum practice income guarantee.

The negotiators have also considered using census-based lists rather than registered lists. They have concluded that an immediate move to registered lists would relatively disadvantage those with accurate patient lists but that a move to using registered lists is their ultimate aim.

A copy of the letter of 17 April has been placed in the Library. The negotiators are committed to sending clear guidance to all general practitioners on calculating potential income under the new contract. Implementation of the contract would follow the results of a ballot of the profession.