well attended meeting in Huddersfield (80
GPs out of 120) with input from the health
authority and oganised by the commissioning
executive. the executive had felt that we
should aim for level 2 by april 99 and put
this to the meeting, the ha presented a
'provisional' plan to split hudds into a
'rural' pcg (popn 80k) and an 'urban' pcg
(popn 140k), the rural group would happen to
contain a like minded group of gps
comprising most of the few fundholders in
this neck of the woods and the tpp all of
whom are very keen to set up a pcg at level
2, this is likely to be supported by the ha,
lots of brownie points at region. meanwhile
the urban pcg is set to flounder. if there
is a capitation (and even weighted) budget
division between the two pcgs then i suspect
that the urban pcg will quickly go bankrupt
or suffer infinite waiting lists or find
their non-ring fenced gms budget poached
into to prop up the deficits (this is based
on an assumption that the urban , largely
singlehanded gps will have significantly
higher prescribing costs and referral rates,
no evidence for this....). the rural pcg
will develop outreach clinics, threaten
moves of contracts to neighbouring providers
and suck resources away from the urban
population
our next step to be based on an exit poll
from the meeting
plenty of gps not convinced of the need to
ration
is level '0', the 'work to rule' option
worth thinking about, cos it looks as if
we're going to be shafted either way
owen dempsey
general practitioner, HGPCE
huddersfield, 01484-654504
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