On 04/27/98 05:02:21,  "Peter Fink" <[log in to unmask]> wrote:

>The point of conflict is likely to come when guidelines have been
>agreed within the PCG for attaining practice prescribing budget
>targets. If practices are found to be over target they will be offered
>support in the form of; peer advice, pharmacist advice or possibly
>extra practice nurse time etc. if they wish to take this.

How very neece!

Not even a slap on the wrist?  All rosey and chumy eh?

>Where the maverick  practice is within the target budget there will be no 
>conflict.

Definition of 'Maverick Practice' please.

>Where the maverick practice is outwith target budget  then the PCG will give 
>notice of action to be taken should there be no move towards target budget 
>within say six months. This action is likely to be a reduction in GMS 
>reimbursement for practice staff.

Oh,  no longer rosey and chumy then?

What is the difference here between the 2 sets of practices?

I believe that the Minister's response (to be published this week) to
the results of the 'GP' survey include something along the lines: "of
course, no Practice will be obliged to participate in the activities of
the PCG"

Perhapes the 'Maverick Rule Makers' are on the rampage already.

Alan Milburn:  take note please!

>This is the action which is most likely to influence GP behaviour  and
> it will partially reimburse the remaining members of the PCG for
>having to subsidise the maverick practice's prescribing budget. 

The logic of your argument does not need PCGs to implement.  The above
scenario happens already as discussed previously on this list.

But it is alright for the maverick practice to subsidise the goody
goody,  albeit,  over budget Practices?

>I think the LMCs will have a lot of difficulty supporting GPs in
>conflict with PCGs, especially GPs whose attitude and stance is seen to
> be unreasonable and out of step with all their clinical colleagues.

I think the days of LMCs are numbered.

I think the more likely scenario would be:  see you in Court!

Some of us who feel vuknerable are taking top legal advice ;-)

>The area of clinical governance is also likely to cause conflict with
>maverick practices

Again,  not non-MPs?!

In that sense,  all I have to do is be goody goody,  over spend my
budget,  to hell with clinical standards and as long as I am not a
'maverick' practice,  I'll be alright JohnJohn??

>I doubt anything will begin to bite until April 2000.

Good,  the 'Bug' will bite before then,  so we are *all* alright then.

>Comments?

I am deeply and truly amazed!

With attitudes like these,  your colleagues must think you a treasure:-)
Lucky them!

KT says:  "I will not say I cannot wait"

Why not?  It's gonna be best entertainment of the century!

Can't wait ;-)

Ahmad

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Dr Ahmad Risk
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