Press release - ballot set to open on the new GP contract
29 May 2003
Family doctors throughout the UK are to be balloted next week to see if the proposed new contract is acceptable to them. The BMA’s General Practitioners Committee (GPC) decided today to send out ballot papers on Monday (2 June 2003) with a closing time for return of 10.00 hrs on Friday 20 June.
The ballot will be run by ERBS (Electoral Reform Ballot Services) which will send the forms to the 43,000 GPs and GP Registrars. They will be asked: Do you wish to see the proposed new GMS contract implemented? Doctors will be asked to indicate either yes or no. Internet and telephone voting will also be available.
Today’s decision by the GPC not to delay the ballot any longer was taken in the light of improvements secured over the last two weeks. These include :
- A move to using registered lists of patients for resource calculations rather than ONS census based data.
- Removal of a financial penalty for practices using the Minimum Practice Income Guarantee
- Agreement on the use of disease prevalance data at practice level when calculating payments in the Quality and Outcomes Framework
Dr John Chisholm, chairman of the BMA’s General Practitioners Committee, commented: “GPs asked for a new contract that was better for doctors and better for patients. I believe this contract delivers that. It is the right way forward for general practice. It meets the objectives laid down by the profession in the National Survey of GP Opinion, and it will deliver high quality care for patients. I urge every GP in the UK to use their vote. The future of general practice is in their hands.”
Most GPs work under the current GMS (General Medical Services) contract, but a significant minority of family doctors work under local contracts called PMS (Personal Medical Services) contracts. Ballot papers will go to all PMS GPs as well as to GMS GPs and family doctors in training (GP registrars). The vote will be a UK-wide one with no separate counts in the devolved countries.
If the contract is accepted, all GMS GPs will transfer to it automatically in April 2004. A permanent minimum income guarantee has been negotiated to ensure that no practice loses money as a result of the switch to the new contract. Many stand to gain significantly over the first three years. PMS doctors will be able to transfer to the new GMS contract if they wish to.
Some elements of the new contract would be introduced immediately if GPs vote in favour. This would include a pay uplift in the current financial year of 11% including money to allow practices to prepare for the introduction of the new Quality and Outcomes Framework next year.
Ends
Notes to editors
The UK is critically short of GPs. The intensity of workload and a feeling of inability to control their professional lives, has led to an unprecedented dip in the morale of family doctors. Negotiations with the Department of Health to improve the current GMS contract were making no progress.
In May 2001 the BMA balloted all GPs asking if they were prepared to consider resigning from their current NHS contract if a new contract could not be negotiated coupled with negotiating rights for all GPs. The overall UK-wide response rate to the ballot was 66% with 22,380 GPs sending back their ballot forms. Of these family doctors, more than eight out of every 10 GPs (86%) voted yes - they would consider resigning if a satisfactory outcome was not reached by April 2002. Similar high response rates and overwhelming "yes" votes were returned in all four countries of the UK.
Negotiations on a new GMS contract began in early Autumn 2001 after the Governments had appointed the NHS Confederation to act as their negotiating agents. In April 2002, the framework of the proposed new contract was published and a ballot of all UK GPs was held to find out if the framework was an acceptable basis on which to move forward to a detailed priced contract. In the ballot on the new contract, 75.8 per cent of GPs voted yes, giving a clear signal to enter the final stage of negotiations.
Plans to publish the final contract in January 2003 had to be delayed. The contract was published on 21 February 2003 with supplementary pricing and details sent to GPs in the following weeks. The information included a mailing of indicative estimates of the global sum individual practices would receive if the new contract was implemented. Many practices discovered this would result in a loss of income under the new contract. As a result of the crisis of confidence this caused, a Minimum Practice Income Guarantee was negotiated to be permanently available. This guarantee ensures that no practice will lose money under the new contract. A revised ready reckoner was made available on the BMA website to enable practices to calculate their own incomes to verify this.
Primary legislation is needed before the proposed new contract can be fully implemented. It would enable Primary Care Organisations, for example, to provide GMS GP services directly so that one of the major benefits of the contract – the ability to opt out of out-of-hours responsibility for patient care – could be implemented while protecting services to patients. This need for legislation carries with it deadlines for parliamentary activity.
A special meeting of Local Medical Committees (LMCs) which represent GPs locally was held on 14 May. There was a call to delay the ballot on the new GP contract’s acceptability while further negotiations took place to secure improvements. Today’s decision by the BMA’s GP Committee, was that sufficient changes have been secured to ballot the profession immediately.
The changes secured include getting rid of a penalty equivalent to the value of 100 quality points (roughly £7,500 per practice in 2004/05 and more the following year) for those practices receiving the minimum practice income guarantee (MPIG). Instead no practice, whether receiving MPIG or not, will have penalties imposed providing it achieves at least 100 points on the quality scale in 2004/5 (150 in 2005/6).