The BMA has called for GPs and CCGs in deprived areas to be given enhanced payments, giving greater impetus to the GPC’s attempts to renegotiate the Carr Hill formula.
A motion calling on the BMA to negotiate for ‘enhanced deprivation element in capitation payments for clinical commissioning groups and general practitioners’ was passed at its Annual Representatives Meeting in Edinburgh today after a close vote.
This gives BMA-wide backing for the GPC’s controversial decision to look into a renegotiation of the Carr Hill formula, after it had previously shelved a review in order to create a period of stability for practices.
The motion also means that the BMA will push for NHS England to change its funding allocations for CCGs, after the NHS Commissioning Board - as it was known - rejected the idea of adopting the ‘fair shares’ funding allocation in December last year, which would have taken deprivation factors into account.
A BMA spokesperson said this motion will allow the GPC flexibility in its negoiations. He said: ‘A lot of motions aren’t designed to have specifics which mandate parts of the BMA - the BMA and negotiators have flexibility to look at how they take this forward.’
Dr Pamela Martin, a GP Lewisham, proposed the motion as she said caring for deprived populations requires extra resources when compared with affluent patients of the same age or sex.
She said: ‘We had a GP join us from south England. He just shook his head and said “I can’t believe how many unworried unwell there are here”. Caring for them takes time. And time is money. And that’s not recognised. It’s certainly not recognised in QOF, it’s not recognised in any payment systems.’
Under the current system, Lewisham GPs do not receive the resources needed to care for their population because patients are younger than average, despite being one of the most deprived boroughs.
She said: ‘In Lewisham we have to treat 200 more patients for free. Because our patients are more deprived than average, they are also younger than average. Money isn’t the only answer to health inequalities but it is an important enabler. Until this is recognised we are battling against inequalities.’
She added: ‘The unworried unwell are dying younger sooner, and their suffering continues. Doctors are burning out trying to help them.’
However, GPC professional fees and regulation subcommittee chair Dr John Canning opposed the motion.
He said he practises in Middlesbrough, which is a deprived area with a low life expectancy. But improving health inequalities are achieved through jobs and work, he said, rather than ‘fiddling the economy’ through health funding.
‘If you want to improve health inequalities, you change the economy, not the health service’ he said.
Motion in full
That this Meeting believes that caring for deprived populations requires extra resources compared with age and or sex matched affluent populations in order to reduce health inequalities, and that this should be recognised by an enhanced deprivation element in capitation payments for clinical commissioning groups and general practitioners. This Meeting calls on the BMA to negotiate such enhanced payments.
