Minister holds talks to avert revolt by GPs

ALAN Milburn is holding crisis talks with leaders of 27,000 family doctors to head off a revolt over the Government's plans for reforming the National Health Service.

British Medical Association leaders who represent the GPs have warned the health minister that they could ballot the doctors, if he fails to make some concessions over the way the new system is to be financed.

Mr Milburn had talks with Dr John Chisholm, the GPs' chief negotiator at the BMA, over dinner at the Commons to try to reassure the doctors.

The health minister yesterday said he would be writing to the General Medical Services Committee before a crunch meeting next Thursday in response to their demands, but it is unlikely he will be able to meet their demands.

Dr Chisholm warned that the GPs were very angry, and growing increasingly worried about the proposals to make them join primary-care groups covering around 100,000 patients by April, next year.

"The reality is unless these issues are addressed in a way that is widely perceived as being satisfactory, I think that GPs are likely to walk away from the system. They fear that patient care is going to be affected if they cannot refer and prescribe in a clinically justifiable way in the interests of their patients."

Mr Milburn has reassured the GPs that they will retain their status as independent contractors in the NHS, they will keep their clinical freedom and they will be allowed to overspend on their annual budgets, in spite of cash limits.

But the Government has so far refused to move over demands by the GPs to ring-fence the money GPs receive for computers, increasing the size of their surgeries, and hiring more staff, which is counted as part of their annual income.

They fear that they could lose the money if they join groups of other GPs who have other priorities. The GMSC leaders are facing a censure motion at the BMA conference in June for being more militant against the changes.

Mr Milburn has warned the BMA that the doctors would be making a serious mistake if they resist the changes. "They are either for us, or against us, but they won't stop the changes going through," he has told them.

The White Paper laying out the changes expressed hopes that GPs would be in the driving seat of the new NHS, and after Labour's landslide victory, it was believed the GPs were wholly behind the plans.

Mr Milburn privately doubts the extent of the rebellion, and there is no prospect of GPs leaving the NHS in large numbers to go private, like dentists under the Tories. But ministers are growing alarmed at the continued resistance of the family doctors, who are essential to making the changes work.

Mr Milburn made a conciliatory move yesterday by warning health authorities they had to consult GPs before establishing the primary care groups.

"I am shocked when GPs write to me and say they have never ever met the chief executive of the health authority," he said.