This item was published during the term of a previous administration that ended in April 2007
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Primary Medical Services Bill published
24/06/2003
New legislation will help make local health services in
Scotland more responsive to the specific health needs of
local communities, while providing a better deal for GPs,
Health Minister Malcolm Chisholm has said.
The Primary Medical Services (Scotland) Bill, published
today, will be backed up by record levels of investment
rising by 33 per cent from £433 million in 2002-03 to £575m
in 2005-06, and will be used to introduce a fairer and more
flexible contract for family doctors.
This will include a system of rewards for GPs who
provide extra services, and will mean an enhanced role for
other members of the primary care team, such as practice
nurses and health visitors.
Mr Chisholm said:
"Over 90 per cent of patient contacts with the NHS are
with the primary care team, and GP practices play an
essential role both in treating patients and in promoting
health improvement.
"The Primary Medical Services Bill represents the
biggest reform of the primary care sector in Scotland since
the 1950s. It will help to simplify and streamline the
primary care infrastructure, reducing bureaucracy and
creating the pay system and the quality patient services we
need to take Scotland's local health services into the 21st
century.
"Direct day to day contact with patients means that GPs,
practice nurses, health visitors, are better informed about
the health needs of their local communities than central
government can ever be. For the first time, this new
legislation will allow Health Boards and GP practices to
agree locally the services that are needed for their
area.
"The Bill will also introduce a payment system based on
patient numbers and needs, not doctor numbers. When a GP
leaves a practice, the patients don't leave with the GP,
and nor do the health needs of the local population change.
That is why GPs will now be paid according to a fairer
system which takes into account not only the number of
patients in a practice list but also the health needs of
those patients, for example levels of deprivation and
disease.
"This means that if a GP leaves a practice, practice
income will not be reduced, and practices will have the
flexibility to use this extra income either to employ
another GP or even another member of the primary care team,
such as a practice nurse.
"Encouraging practices to make full use of the skills of
the whole primary care team will give GPs more flexibility
to control their own workload and concentrate on patient
care, while giving other members of the primary care team
the opportunity to take on new responsibilities.
"The legislation will also give Health Boards the power
to employ salaried GPs when they feel necessary, for
example to help attract and retain staff in rural areas.
And it will reward the quality, as well as the quantity, of
patient care, encouraging the provision of a wider range of
services at GP surgeries, such as diabetes or asthma
clinics, or minor surgical procedures which would
previously have been carried out in hospital.
"We recognise that local health services need not only
the staff, but also the tools to do their job effectively.
That is why spending on modernising primary care premises
will rise over this period from £34 million to £69 million,
and spending on improved IT equipment from £2.5 million to
£11 million.
"Through increased investment in staff and
infrastructure, by encouraging new ways of working, and by
recognising and responding to the needs of patients, I hope
that we can continue to develop better working conditions
for the whole primary care team and more accessible,
quality services for patients."
Dr David Love, Joint Chairman of the BMA's Scottish GP
Committee, said:
"The BMA is delighted that GPs have given overwhelming
support for this nationally agreed contract that will see
substantial new investment for general practice.
"This new contract provides a sound foundation on which
to revitalise general practice as it encourages, recognises
and rewards high quality services for patients. We believe
that general practice is the cornerstone on which the NHS
is built and hopefully this new contract will help address
the recruitment and retention crisis. There is still a lot
of work to do to ensure satisfactory implementation of the
contract and we look forward to working with the Scottish
Executive to ensure smooth implementation across the
service."
The Primary Medical Services (Scotland) Bill was
formally introduced to the Parliament on Monday June
23.
It will begin its passage through the Parliamentary
stages after the summer recess. It will be followed
by secondary legislation - the new GMS Regulations - which
will set out the detail of how the contract is to be
underpinned.
The aim is to have both the Bill and the secondary
legislation in place for April 1, 2004.
The proposals contained with the Bill are the result of
almost two years' negotiation with the GPC and NHS
Confederation on a UK wide basis.
They reflect the UK agreement on the way forward for
GMS. The contract has twice been subject to a formal
consultation with the profession. On April 17, 2002, the
NHS Confederation and the UK General Practitioners
Committee (GPC) agreed the framework for the new UK-wide
contract.
The four UK Health Ministers agreed its principles. On
Friday June 20, 2003, 79.4 per cent of GPs - over half of
the total profession - voted in favour of a new contract as
part of a UK ballot of GPs.
The Executive also intends to bring forward regulations
which will set out a process for resolution of disputes.
This will ensure that any dispute follows a single, easily
understood procedure and adheres to the principles of the
European Convention on Human Rights.