Wot about the GPs? A Guide to the GP Contract.

About two years ago, Harthill became the centre of the media world in Scotland; or at least, the medical media world. A GP practice had dissolved due to a disagreement between the partners and NHS Lanarkshire had put out the tender on an APMS contract (Alternative Provider of Medical Services). Basically what this meant was, that not only could GPs apply to run the practice, but private companies could also apply and they did not even need to be health companies. As long as they maintained at least one GP in the practice, they could run it. The company that applied was Serco, which is a utilties company. Had they succeeded, the likely scenario would have been this;

1. Hollow out the practice. They are only legally required to have one GP; replace the others with nurse practitioners.

2. Bring in a pharmaceutical company. Pharmaceutical companies are always looking to promote their brands of drugs and pay big bucks to practices willing to promote sales. In Harthill's case, this was Astra Zeneca.

3. Slim down the patient list. A large number of elderly, chronically ill, or disabled is not good for profits. Appeal to the worried well, who are easy to look after and who do not eat into the shareholder profits.

Fortunately, Serco did not succeed. My own group, the Scottish Health Campaign Network and others got wind of it and we headed them off at the pass. But these companies have not gone away. They have been doing this down in England and even Richard Branson has been trying to get in on the act.

One of the difficulties in closing this loophole is European law. If a GP practice is small and is worth less than a certain value, then it does not need to be put out to open tender. If it is bigger and goes above a certain value, then it does need to be put out to open tender under European contract law. Guess what's happening. GP practices are merging and are coming together under one roof in big health centres. What's the next move? That's anyone's guess. But this battle is not over and I expect another attempt at a takeover in the next couple of years. Everyone needs to be alert to this, because primary care makes up 90% of the NHS and if this goes ahead, it will be the end of the NHS as we know it. If I am elected, it is something I will keep a very close eye on and oppose where necessary.

If you're a GP and reading this, try not to have nightmares..