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Rural family doctors' surgeries facing closure

By Western Morning News  |  Posted: March 04, 2013

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Family doctors closure threat

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Small rural doctors' surgeries across the Westcountry could be forced to close because of contract changes being forced through by the Government.

The warning from the Family Doctor Association comes amid growing disquiet among GPs over a move to switch £164 million of funding away from administrative duties to incentives for them to target certain medical conditions.

Dr Peter Swinyard, chairman of the association which represents more than 1,000 practices, said the changes would see smaller practices squeezed "until the pips squeak".

He warned GPs had no time to take on the new changes which would affect smaller surgeries the hardest.

He said: "The pips are squeaking in general practice and there is no room left for adding yet more work without adequate resources.

"Smaller practices will find dealing with these things much more difficult than most, because they haven't got the strength and depth of larger practices to spread the workload."

Doctors in the region have already expressed their own concerns, with a survey revealing fears that two-thirds of surgeries in the Westcountry may struggle to remain viable after the changes.

Peter Merrin, chairman of the Cornwall and Isles Of Scilly Local Medical Committee, said they shared the concerns of the Family Doctors' Association.

"The proposed contract imposition comes at a time when morale among GPs is falling as a result of the increasing demands of an ageing population with increasingly complex medical and social problems," Dr Merrin, a GP at Perranporth, said.

"In addition there is a steady transfer of work from the hospital sector into the community increasing the workload for all health workers in the community sector.

"We see the new contract as a threat to small practices and are urging family doctors to look at ways in which they may share some of their workload with other practices.

"This doesn't necessarily mean merging practices but it might mean better and smarter use of our resources. As yet we are unclear how this will impact on patients."

He added: "In Cornwall, we remain committed to providing high quality general practice to all of our patients but the ways in which we deliver that care may and probably will have to change as a result of increasing workload and the new contract."

Negotiations between the Department of Health and the British Medical Association on changes to GP working practices broke down late last year. Consultation on the Government's proposals has now closed and an imposed contract is likely to come into force from April 1.

The Department of Health has insisted that no money has been taken away from GPs and it had offered extra funding.

Ministers have argued that the changes will lead to fewer deaths from the main diseases and more cases of diabetes, dementia and other conditions being diagnosed earlier.

But Dr Swinyard said surgeries in rural areas which were small "by necessity" and those in towns and cities which were small "by history" would be affected.

A change to the way practices were paid to provide locums, he said, would also see smaller practices losing out.

The depth of doctors' concerns was revealed earlier this year.

Almost half of the 6,000 GPs in Cornwall, Devon, Avon, Gloucestershire, Somerset and Wessex responded to questions put by their Local Medical Committees (LMC).

Two out of three (67%) said their practice would "struggle to remain viable" if the changes went ahead while almost half (48%) said their current workload was "dangerously unsustainable".

Dr Mark Sanford-Wood, chairman of the Devon LMC, described the "personal GP system" enjoyed by patients as being "under serious threat from the Government's plans for the future".

Health Minister Lord Howe said it was considering the responses to the 12-week consultation and would "announce the outcome shortly".

"Our proposed changes to the GP contract are designed to improve the care offered to patients," he said. "The consultation – and hearing the views of GPs and other stakeholders – will help us decide how this can be achieved."

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7 comments

  • Stork  |  March 04 2013, 4:47PM

    Mister Donut When Labour were negotiating a new deal with GPs'. The GP negotiating team, for a laugh-and to start the ball rolling, offered " GP's finish out of hours working, and in return, accept a £6,000 p.a. wage reduction". The GPs' negotiating team thought this would create hilarious laughter from the Government negotiating team, and relax everybody around the negotiating table. However, the Government team said, "ok ", and the GPs' team couldn't believe their ears. I know someone who was very close to the GPs' team, and they told me ! I also know that many GP's don't work a full five day week at their surgeries. A lot of them have other work, teaching, private medicals, factory in-house Doctors, etc and earn well into six figures. Having said that, many GPs' hate their jobs, so boring, but can't give up the money and moreorless 9-5 lifestyle.

  • Free2opine  |  March 04 2013, 12:24PM

    @nickthompson.......you do talk some drivel at times. Time for people to realise that the only party with any interest in keeping the NHS is UKIP. UKIP will: 1. Direct the majority of health care spending to elected County Health Boards, making spending decisions directly accountable to the public locally. 2. Dramatically cut the Department of Health and bring in professional procurement skills to reduce the huge amounts of money wasted in procurement and resource allocation. 3. Prioritise UK taxpayers and citizens, ending health tourism by requiring all those without entitlement to pay in advance. 4. Restore traditional nursing, especially the non-university-trained State Enrolled Nurses or equivalent. 5. Engender a Universal Duty of Care to ensure that everyone is responsible for reporting inadequate care and driving up standards. Introduction The UK Independence Party is well aware of how highly the NHS is valued by the people of this country and has no plans to make fundamental changes to it. In particular, the principle of treatment free at the point of delivery will be retained for British subjects. However, the UKIP is exploring alternative models, such as those used in Australia, Germany and the Netherlands, taking the best of the NHS and the alternatives. In due course this should lead to us being able to offer people a choice, should they wish to use it.

  • MisterDonut  |  March 04 2013, 11:01AM

    The coalition government, not far right by any stretch of an unbiased imagination were left with huge debts by the last Labour government, who once again brought this country to it's knees. They were also left with another legacy, when Labour renegotiated GPs contracts they mistakenly and unwittingly left them with an overwhemingly good deal. Most GPs were so surprised by the deal offered that they could afford to give up 'out of hours' work. The coalition government have a lot to sort out.

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  • nickthompson  |  March 04 2013, 9:44AM

    DipStick: At the last General Election the Tory manifesto made it quite clear that should they be fortunate enough to form the next government they would push through a programme of severe spending cuts,which we are now witnessing,so those that choose to vote for the party that historically has never been in favour of the welfare state should not be surprised,but indeed pleased with the cuts reffered to in the headline.

    |   3
  • DipStick  |  March 04 2013, 9:28AM

    @nickthompson: """""No problem here, those that live in these small villages are ( in the main) Tory supporters .....""""""""" What a load of the stuff that makes the grass green in Texas! As to your implication that it's all the "Tories" fault, which party was in power when the GP's contracts were negotiated a few years ago, which led to vastly increased salaries and less hours worked? Oh, that's right, it wasn't the Tories ..... As to the ""...switch £164 million of funding away from administrative duties to incentives for them to target certain medical conditions ..."", this is more central control from politicians (and they are ALL the same) trying to manufacture positive press from patient "successes". GPs should have enough money to treat patients as they find them, not just treat certain prescribed "important" illnesses. DS

    |   -3
  • toffer99  |  March 04 2013, 9:23AM

    "The NHS is dead in our hands."

    |   4
  • nickthompson  |  March 04 2013, 9:14AM

    No problem here, those that live in these small villages are ( in the main) Tory supporters,so are in fact getting exactly what they voted for.

    |   3

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