BMA wins guarantees on primary care groupsBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7149.1927 (Published 27 June 1998) Cite this as: BMJ 1998;316:1927
General practitioners in England have won substantial concessions from health minister Alan Milburn over the formation and running of primary care groups.
After extensive negotiations, the minister has agreed to allow GPs the right to decide locally whether they will be in the majority on primary care group boards. They will also be allowed to decide whether they wish a GP to chair the board. This was one of seven demands that the BMA's General Medical Services Committee (GMSC) put to Mr Milburn last month (16 May, p 1481).
Mr Milburn gave an assurance that the establishment of primary care groups will not affect GPs' independent contractor status. He also gave a commitment to retaining the independent review body and the existing mechanisms for paying GPs, and to consult with the GMSC on all aspects to do with NHS general practice. GPs would continue to be free to prescribe and refer, with patients guaranteed the drugs, investigations, and treatments they need. Overspends would be managed within health authorities' general allocations as they are now.
It is less clear how much money will be in the pot for the setting up and continued funding of primary care groups. There is £22m ($35m) already made available, but any further funds will not be announced until after the comprehensive spending review—due later this summer. All who work for shadow primary care groups will be “appropriately remunerated.” Continuing funding of primary care groups will be “fair and transparent.”
Another area of concern was the protection of general medical services cash limited funds. Mr Milburn guaranteed that the level of investment in primary care infrastructure will be maintained and increased to match inflation.
There has not yet been a decision on whether primary care groups will inherit health authority debts. But John Chisholm, the GMSC chairman, said that once the comprehensive spending review was announced the negotiating team would be “back through the minister's door” to make sure this did not happen.
The GMSC, at last week's meeting, congratulated the negotiating team and decided that the proposals outlined by Mr Milburn formed an acceptable basis for GPs to progress their involvement in primary care groups. The GMSC will ask the local medical committee conference to support their decision.