Speech from the Chairman of the Professional Fees Committee, Dr Peter Holden
Thursday 3 July 2003
Chairman in presenting my report to the ARM may I take this opportunity to thank the secretariat for their support during the year in particular Chris Hartley who has held the show together during a time when there has been 100% staff turnover and currently a 66% vacancy rate.
The reason that you have not had this report tabled earlier is that several crucial key pieces of the committees’ work for the session could not be finalised until the outcomes of new contractual arrangements for General Practice were known. GP remuneration rates inform key agreed principles with outside bodies concerning the pricing structures of agreed, recommended and suggested fee scale categories. Some o fee scales previously published are now prohibited from publication by the Competition Act. However those fees which we are permitted to publish have now been moved to public section of the BMA web site in the interests of transparency.
Locum fees
The Office of Fair Trading remains unconvinced of the case for permitting us to publish suggested locum fees. Currently we are instructing commercial solicitors and Counsel to help us with this issue. We are collecting further data to further bolster our case with the OFT. There is now a very strong case for considering asking the DDRB to price NHS GP locum work.
Benefits agency
SchlumbergerSema now manage the medical assessment component for the Benefits Agency. We met the new management in October and put the case for improvements in the terms of service for doctors (eg mileage, abortive visits) but since then have heard nothing. Their complaints procedures remains deeply unsatisfactory as does their management style. The Benefits Agency Government contract is due for renewal in two years. Our emphasis is turning to convincing potential bidders and the Government of the urgent need to renew relations with the profession on these issues, and properly to recognise the market in which they are trying to recruit doctors, a group who have not had a substantive pay rise since 1992. We await with interest the latest National Audit Office report- the third in 6 years- into this flawed agency.
Collaborative arrangements
We have achieved the alignment of collaborative fee with other NHS fees and allowances to an April annual cycle from July. We have yet to convince DDRB and Department of Health that the baseline pay rate is too low
Medico-legal fees
We have met with the Lord Chancellor’s Department and are hopeful that they will budget for increases in fees in line with new GP pay next year. Talks have also started with the CPS on the vexed question of professional witness fees.
Paternity testing fees
will rise by 40% in the autumn, and be linked to the Treasury rate in future.
Personal Medical Attendants fees
These have risen by 100% this year. During last summer we secured an immediate increase from the ABI from £31.00p to £54.00p and the fee rose to £60 this April 1st.
Future fees increases
Because the new GP contract no longer contains an IANR figure the committee has been considering how to approach the calculation of annual increases in professional fees (which have traditionally been linked to IANR) for 2003-04 and future years.
The new GP contractual arrangements provide for estimated increases in net profit per GP from a variety of funding streams equating to 11.3% in 2003-04, 19.0% in 2004-05, and 25.5% in 2005-06, all from a 2002-03 base. A recommendation along these lines for fee increases will be made to Council later this month. Negotiations will then commence with the many outside bodies with whom we agree fees. It is possible that many organisations will be unable to implement the 2003-04 increase of 11.3% immediately as this will not have been budgeted, but they will all be asked to commit to an increase of 19% in from 1st April 2004.
The facts are clear. The market value of doctors has shifted up a gear and we must all be resolute in standing firm and not working either at a discount or at unrealistic marginal cost prices. Those with whom we contract must either understand this or accept that the work will not be done in the future.
RB the value of a doctors’ time is in your own hands
I move.