Medicopolitical Digest

Non-core services will not be negotiated nationallySome European doctors face discriminationProfession secures changes to primary care billMore patients wait longer for hospital admission

BMJ 1997; 314 doi: (Published 01 March 1997) Cite this as: BMJ 1997;314:684

Non-core services will not be negotiated nationally

GPs have turned down a proposal to investigate the feasibility of negotiating item of service fees for non-core services outside target net remuneration.

At last week's meeting of the General Medical Services Committee Dr Peter Fellows said that many doctors were unhappy about local negotiations on non-core services; they were time consuming and local medical committees did not enjoy trade union protection. He quoted the chief executive of the Cornwall and Isles of Scilly Health Authority who had indicated that £28 an hour was the rate at which he would value GPs' secondary care work in a primary care setting.

But one of the negotiators, Dr Brian Goss, said that it was a fantasy to think that the fees could be negotiated outside target net remuneration. National prices for non-core services could have been negotiated within the pool system but that would simply have led to a redistribution of income. There was also the risk that non-core services might have become a terms of service obligation for all GPs and not a voluntary exercise.

The GMSC's view is that circumstances vary in different places and that local negotiations are based on an understanding of local health service conditions and the …

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