Medicopolitical Digest

BMA will resume talks on out of hours servicesReview body's response to workload angers GPsMPs debate gagging in NHSSupervised discharge gets legal backingExcessive paperwork is hampering primary careDebate continues on reaccrediting general practitioners

BMJ 1995; 310 doi: (Published 25 February 1995) Cite this as: BMJ 1995;310:535

The General Medical Services Committee has accepted an invitation from the NHS Executive to resume talks on payment for out of hours services. There has been a stalemate since the committee rejected what it called the Department of Health's derisory offer of a fixed payment of pounds sterling2000 per principal for out of hours work and a new night visit fee of pounds sterling9 (7 January, p 63). The Doctors' and Dentists' Review Body said that it was disappointed that an agreement had not been reached and it has delayed recommending a scale of fees for 1995-6 until next month.

The invitation came in a letter to the GMSC's chairman, Dr Ian Bogle, offering pounds sterling15m of new money “to support general practitioners delivering out of hours services.” Although the minister for health, Dr Gerald Malone, said in an interview that the money was intended for cooperatives, the letter does not mention cooperatives nor whether the pounds sterling15m is a one off payment. The NHS Executive sets out what it believes are the GMSC's main concerns: that the general practice contract is underpriced; that a price should be put on the whole out of hours period; that the fee element in the proposed new structure was too low; that doctors in rural areas would lose financially; and that cash limited support for practices grouping together to provide out of hours cover should be new money. Mr Jack Barnes from the executive says that it would be inappropriate to price the whole out of hours period, but that the executive would be willing to discuss increasing rural practice payments and the fee element of the new structure. It would also consider placing further funding into the night visit fee element, although this would need to come from changes in fee relativities. …

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