Too many problems with C+B, says Meldrum

  • 15 June 2006

Too many delays and problems have undermined the Choose and Book scheme, according to the leader of the UK’s GPs.

Dr Hamish Meldrum, chairman of the British Medical Association’s General Practitioner Committee, told the national local medical committees’ conference that while the Choose and Book scheme “might be acceptable in principle” it had been the subject of too many problems.

Dr Meldrum added: “Coupled with last month’s admission that the whole Connecting for Health programme may now cost upward of £20 billion, even the enthusiasts are beginning to question just how much connecting, just how much health we’re getting for our money.”

Tomorrow (Friday) LMCs’ will debate motions that Choose and Book is “deeply flawed and not fit for purpose” and that it should be suspended immediately. It will also hear calls for confidentiality concerns over the NHS Care Records Service to be resolved before any further progress is agreed on implementing the National Programme for IT.

In his keynote address to the conference Dr Meldrum defended the amount GPs’ earn, which he claimed was an average of £95,000 in 2005/6, praised GPs’ efforts on the Quality and Outcomes Framework and called on the government to do much more to incentivise and co-operate with GPs over practice –based commissioning.

He told the conference: “Deficits, a crude, inflexible system of Payment by Results, lack of PCT cooperation or an insistence that practices take on so-called referral management schemes that are basically rationing by another name – it’s no wonder that in many areas it just isn’t happening.”

Dr Meldrum also said that while he believed the white paper on care outside hospital was “in many ways a champion of primary care” he argued that there was no details, no coherence and no money to underpin its conclusions.

Better links with social care were something no-one would argue with, he said. But he added: “This has been the Holy Grail of successive governments yet I can find nothing in the White Paper to reassure me that this will be any better than a Monty Python quest and will resolve the conundrum of merging one service that is free at the point of use with another that remains means-tested.”

Dr Meldrum claimed consultation and clinical engagement with the profession were vital for all governments.

He added: “Working together, we might just get out of this mess. If governments marginalise us, only talking to those who agree with their every word, GPs will stay on the sidelines. Governments, with family doctors as mere bystanders, you’ve little chance. If we’re against you – none at all.”


Dr Meldrum’s speech


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