Professionalism and duty of care re-established for GPs in UK after Labour messed up.

New GP contract heralds return of ‘proper doctors’

A new contract for GPs will see the return of “proper family doctors,” responsible for round-the-clock care and with dedicated help for the elderly, the Health Secretary says

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The deal agreed with the British Medical Association (BMA) has been heralded as the biggest shake-up since Labour introduced changes which allowed thousands of doctors to abandon responsibilty for out-of-hours care.

Under the contract four million elderly patients and those with complex conditions will be given a named GP, personally accountable for their care at all times.

Ministers say the change is crucial because the failure to care for older patients has causing a spiralling crisis in NHS emergency care, with millions of patients admitted to hospital because they could not get help in time from their GPs.

Under a deal introduced by Labour, the majority of family doctors dropped responsibility for out-of-hours care, yet saw their earnings rise instantly by almost one third.

BMA negotiators later admitted the terms, which brought average GP incomes to more than £100,000 were so generous that they thought the Government was “having a laugh”.

Since then, there have been a succession of scandals in which patients were failed by locum doctors, including a notorious case when a pensioner was killed by an overdose of painkillers administered by an overseas medic working his first shift.

The new deal will mean that GPs are personally responsible for the care of all patients aged 75 and over, around the clock, regardless of who delivers it – as well as for the care for younger patients with complex health needs.

Older patients will also be promised same-day access to their doctors, via telephone consultations, while GPs will be instructed to draw up “personalised care plans” so all frail and elderly patients are properly looked after.

Jeremy Hunt said last night: “Labour’s 2004 GP contract broke the personal link between GP and patient. It piled target after target on doctors, took away their responsibility for out-of-hours care and put huge pressure on our A&E departments. This Government has a plan to sort this out. Today’s announcement of a new GP contract is a vital step.”

Ofsted-style ratings measuring the performance of GP practices as outstanding, good, requires improvement or inadequate, will be published in every surgery by 2015, while data will be published scrutinising the quality of out-of-hours care for all patients.

Government sources said the reports would be detailed and “unapologetically frank” informed by close observation and conversations with professionals and patients.

Mr Hunt said: “We are bringing back named GPs for the vulnerable elderly. This means proper family doctors, able to focus on giving elderly people the care they need and prevent unnecessary trips to hospital. This is about fixing the long-term pressures on our A&E services, and freeing hardworking doctors to improve care for those with the greatest need.”

Since 2004, GPs pay has been dictated by hundreds of targets. Under the system – derided by critics as “points mean prizes” – income can be dictated by how many patients are weighed, asked about their alcohol intake or given lifestyle advice.

Under the new deal, which will be introduced in April, more than one third of the indicators will be scrapped, which the BMA said would allow thousands of GPs to attend to their patients, instead of their computer screens.

Dr Chaand Nagpaul, Chairman of the BMA’s GP committee, said: “This is resurrecting what used to happen: it means tailored and personalised care.”

“The 2004 contract brought unprecedented bureaucracy and chasing of targets and box-ticking. We have removed a swathe of targets: what this is doing is giving GPs time – time to care. Doctors will be able to look at the patient in front of them, not the computer screen.”

Under the targets framework, doctors have been paid for improving their handwriting, or ensuring staff undergo training, or for asking patients how often they do activities such as DIY, cooking or gardening.

Dr Nagpaul said: “Even today GPs up and down the land are asking these questions – how often patients cycle, garden or cook, how often they walk – and how quickly – checking the blood pressure of fit and healthy people, all the while measuring rather than providing care.”

The deal agreed yesterday involves some compromises, as ministers had orginally indicated that they wanted GPs to take back responsibilty for out-of-hours care for all patients, and further changes are likely to be negotiated in future years.

Dr Nagpaul said: “Given the workforce crisis among GPs it’s right to focus on the patients with the greatest need. I think the Government understsands that with a limited workforce GPs need to use their time wisely.”

The BMA said the terms would not increase funding for doctors – who on average earns £103,000, with more than 600 earning more than £200,000 – but would shift existing resources, so GPs could make better use of their professional judgement.

Andy Burnham , Labour’s Shadow Health Secretary, said: “No amount of spin can hide the fact that David Cameron has made it harder to get a GP appointment. There is nothing in this new contract to correct that.”

“David Cameron cut Labour’s scheme of evening and weekend opening and the guarantee of seeing a doctor within 48 hours. “This announcement will not put an end to patients phoning the surgery at 9am and finding it impossible to get an appointment – many of whom, not happy with a phone consultation, will still turn to A&E.”