please send me the full text, bot not in the format of your '....plus notes'
mail!!
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From: [log in to unmask] on behalf of Mark O'Connor
Sent: 18 June 1998 21:45
To: [log in to unmask]
Subject: Millburns Letter Summary
Below is a faithful summary of the response by Alan Millburn to the GMSC's
11/6/98 showdown.
Good news or bad? I am certainly feeling a little happier :)
1. Independent contractor status
Committment to the national cost-plus contract, the red book and the
independant review body and to consult and negotiate with the gmsc on all
aspects to do with nhs general practice
2. Maintenace of GPs freedom to prescribe and refer
Patients to be guarenteed the drugs, investigations and treatments they they
need. Overspends to be managed within health authority general allocations
as they are now. GP memebership of a pcg or pcg board will not affect their
ability to prescribe and refer in patients best interests
3 Establishment of PCGs with gp led governing boards
GPsHAVE THE RIGHT TO DECIDE LOCALLY WHETHER THEY WILL BE IN THE MAJORITY ON
PCG BOARDS. DEPENDING ON THAT CHOICE, BOARDS WILL HAVE 4-7 GPS, 1-2 NURSES,
1SS REP, 1 LAY, 1 HA NONEXEC AND THE PCG CHIEF EXEC. GPS TO DECIDE WHETHER
THEY WISH TO HOLD THE CHAIR
4. Financial support and training for perparatory work
£22M already available. All who work for shadow groups to be "appropriately
remunerated" Futer consults re remuneration. "Coherent approach to local
im&t develp and invest., with a "rational and streamlined approach to data
collection.
5Continuing resources of pcgs, wiping out of old debts and future overspends
Awaiting the result of Comprehensive spending review but the allocation will
be fair and transparent. Pace of change to be sensitive to local services
and existing committments. Money to be allocated by the Autumn. Overspends
to be habdled at HA level
6. Protection of GMS money - a one way valve
GUARENTEED MINIMUM LEVEL OF GMS EQUIV TO PRESENT ALLOCATION PLUS ANNUAL
UPLIFT FOR INFLATION. OVERALL FLOOR AT HA LEVEL PLUS SUB FLOOR AT PCG LEVEL
FOR STAFF AND PC MAINTENACE. ALL RED BOOK RULES STILL APPLY PLUS ADDED
PROTECTION OF ONE YEARS NOTICE OF CHANGE TO PRACTICES IN ADDITION TO RED
BOOK SAFGUARDS.
7. Role of LMCs
New legislation to ensure that LMCs represent all gps. HAs expected to
cooperate meanwhile in enabling part 1 GP involvement in pcgs HAs to
continue to take advice from LMCs on matters including HIPs
ALSO NEGOTIATED
8 HAs must provide evidence that they have the agreement of GPs and LMCs to
regional offices before a pcgs size or boundaries are approved. Practices
which feel disadvantaged can ask for their views to go direct to Ros via
LMCs
9. Liabilites to remain the responsibilty of HAs and Trusts
10 Incentives for GPs. There will be "new incentives" for all Primary Care
via a national incentive framework.
and lastly 11
Out of Hours development to be ring fenced at HA level. Same arrangements
for management and allocation of fund. Joint annual review of operation and
level of fund
Any one want the full text I can email to the list. Need permission first.
.................................
Dr Mark O'Connor
GP Long Ashton, Bristol
Mob 07970 386379
Home 0117 942 0453
Work 01275 392281/392134
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