Step forward, or step backward?

Released 08/05/2009

by Matt Jane

Should practice income be re-linked to GP rather than patient numbers?

Should practice income be re-linked to GP rather than patient numbers? Dr Hamish Meldrum - one of the architects of the 2004 contracts which de-linked practice income with GP headcount - thinks so.

I have great respect for GPs, of course, but I struggle to agree with Meldrum's reasoning. A practice-based contract, he argues, can lead to a reduction in doctor numbers which means more patients per doctor, and the risk that doctors don't have enough time to focus on each patient.

There are of course some sound worries to address here - no one wants to see GPs more overworked or with inadequate time to treat patients. But isn't this what the changes in the primary care team to see expanded roles for nurses and HCAs have been about?

There are many issues to address in how general practice faces the future, but it seems to me that a flexible and skilled team is key to that, and anything which would undermine this progress could be a retrograde step.

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