GPs' payments could be deferred

DOCTORS in east Suffolk are facing the possibility of having their payments deferred into the next financial year as the health service may not have any cash left in early 2006.

The EADT has learnt that senior staff at Suffolk East Primary Care Trusts (PCTs) have met GPs this week to discuss the option of delaying their funding as they struggle to balance the books.

But the PCTs have stressed that the move is just a “possibility”, with no decisions yet made, and would only happen as an “absolute last resort”.

However, doctors in the county have reacted with alarm at the idea, saying any delay longer than a few days could put their practices at risk.

As they are run as small businesses, they could face problems paying for rates, rent and salaries - and could even have to cut back orders of drugs or buy them on credit if they are dispensing practices, the British Medical Association (BMA) in Suffolk warned.

Jan Rowsell, spokeswoman for Suffolk East PCTs, said last night: “We are facing extreme financial challenges and wanted to share with colleagues in the spirit of honesty, openness and transparency the possibility that without external sources of support we may find ourselves without any cash early in the new year 2006.

“We are working very hard with the SHA (Strategic Health Authority) and the NHS Bank to secure the help we need to avoid this.

“It would be an absolute last resort for us to defer payments to GPs.”

Dr Paul Thomas, from Gipping Valley Practice in Barham, near Ipswich, said: “My first observation is that I have a contract with the PCT and they have a legally-binding contract to me and that contract requires them to pay the fees on time.

“In the past I have been obliged to take the former health authority to the county court for the non-payment of fees and won and that was in 1999.

“I have my mortgage to pay, rent to pay and staff to pay and at the end of the day the business cannot survive if the fees are not paid. I would have a low threshold to seek legal redress.”

Dr John Havard, from the Saxmundham Health Group, said: “It's a sad indictment of the panic the PCTs find themselves in.

“To say 'we are not going to pay any more' is a naive attitude that may get them in contractual problems.”

A spokesman for the BMA in Suffolk - which represents GPs - said a delay of a few days could be understandable in the circumstances but if it was for a few months it could be “quite catastrophic”.

He said: “There would be problems in terms of ensuring the financial viability of the practice; effectively it is asking the GP practices to subsidise NHS staff as they would have to pay for them.

“The partners who rely on the profit of the business to pay themselves might end up either not having any incomes or having to pay from their own resources for staff. It would be a severe state of affairs.”

John Gummer, MP for Suffolk Coastal, who attended a summit on the financial problems with health minister Rosie Winterton on Wednesday , said deferment of payment would be “manifestly and absolutely unacceptable”.

A spokeswoman for the Norfolk, Suffolk and Cambridgeshire SHA, said: “It is the responsibility of the local commissioners and hospital boards to manage within the resources they have available and modernise services to achieve affordable healthcare. The board of each Primary Care Trust will consider recommendations on how to achieve this.”

This month the Suffolk East PCTs also drew up a list of preferred drugs - cheaper brands - and restricted medicines - those that are available over the counter such as cough and cold remedies - as it tries to make the “best use” of its drugs budget.

PCTs in Suffolk have combined debts of £40m and an historic deficit of £38.9m, and are required by the Government to break even within two years.

Any decision on the possibility of deferring GPs' payments, which are understood to be paid quarterly or monthly, will be made by the East Suffolk PCTs board in November.