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Care reforms raise concerns over patient access to GP services

GP services may be affected adversely by new provisions allowing commercial companies to provide primary care through locally negotiated contracts

GP services may be affected adversely by new provisions allowing commercial companies to provide primary care through locally negotiated contracts, according to a study from the Centre for International Public Health Policy at the University of Edinburgh.

The study leaders warned that, as a result of changes to how contracts are drawn up, GPs are no longer bound to provide patients with integrated and comprehensive services.

The research, which was carried out in collaboration with the University of Glasgow and published in the British Medical Journal, focused on changes made in 2003 to general medical services contracts, which opened up GP provision to private companies across the UK.

There are more than 30 commercial corporations now delivering GP services through commercial contracts in the UK to date. The data showed that GPs had reduced control over the range of services provided, with contractors now responsible for providing services "appropriate to meet the reasonable needs of patients".

The researchers go on to say that nationally agreed frameworks for pay and conditions also may not be followed because commercial primary care providers have the freedom to manage financial risk by restructuring staff costs and thus reduce levels and quality of provision.

Professor Allyson Pollock, of the Centre for International Public Health Policy at the University of Edinburgh, warned: "Research in the US shows that the commercialisation of healthcare is accompanied by loss of professional autonomy and reductions in standards and quality of care and access."

Pollock concluded: "The legislation which introduced the new GP contract should be reviewed as a matter of urgency, especially in Scotland and Wales where health is devolved and where governments are choosing to eschew markets in healthcare."

10th September 2007

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