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Potential GP contract changes to global sum are catastrophic

Every instinct tells me I shouldn't say: 'I told you so' but I am going to say it anyway!

In my earlier blogs I cautioned against industrial action over the pension changes, warning that there was a bigger war to be fought over the contract changes, and here we are, with changes to the global sum elements for GMS and PMS practices, and changes to QOF. Now there are battles to be won and lost, and it is critical to pick the battles to fight.

The issues over QOF are irritating and pernicious but not catastrophic. The potential changes to the global sum are catastrophic. The history here is enormously important to keep in mind. The 2004 contract was underpriced, and the DH had to come up with a quick fix to give GPs the funding they needed - and actually only at the level they were earning in 2002/3, so it only put them back to the position they were earning before. This is the background to the MPIG and the correction factor, like a Band-Aid on a sinking ship. The Band-Aid has worn out, we all knew it would, but any replacement has to address the issue that its predecessor was there to protect GPs earnings at their previous level, it can't just be disposed of as an inconvenience. If it is, then GPs earnings will be undermined for years to come.

So while I was cautious over industrial action on pensions, I am not cautious over this issue. Make sure the negotiators are concentrating on this issue, dust off the barricades and fight. This is the issue.

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