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Plans to reward GPs as part of the Government's NHS reforms have been slammed by a leading BMA member.

Dr Laurence Buckman, chairman of the BMA's General Practitioners Committee, told Βι¶ΉΤΌΕΔ Radio 4's File On 4 programme the Quality Premium, which is central to the plans for GP commissioning, could be considered "disgracefully unethical".

In the interview to be broadcast tonight (8pm, Tuesday 1 March, Radio 4), Dr Buckman says they do not understand where the incentive payments, which reward GPs for getting the best care for their patients and making savings for the health service, would come from.

"We don't understand what the Quality Premium means," he commented. "We don't understand where it will come from; we rather fear it will come out of our pay and be paid back to us if we do certain things.

"It appears what we might actually be asked to do is to save money and if we save a certain amount of money we will receive some of our pay given back to us. That is something that is appallingly unethical."

Asked to identify what he sees as "unethical" Dr Buckman responded: "Because I don't believe that I should be saying to a patient 'you can't have treatment because that way I'll get paid'."

He added: "I do accept that doctors should be careful with the expenditure of NHS resources, I think it's important that we don't refer inappropriately or prescribe inappropriately or investigate inappropriately. That's all fine. What I'm not prepared to do is I receive pay – even worse, pay that's been deducted and given back to me – on the basis that I withdraw treatment from a patient. That is disgracefully unethical and most GPs will have nothing to do with that."

But Health Minister Paul Burstow defended the scheme, telling File On 4 Dr Buckman's view was "gross distortion" of what they are trying to do.

"It's about making sure that what the NHS does is focused on delivering the very best outcomes and the best results in terms of patient care and in terms of the clinical success of that treatment and procedure.

"What we are trying to do with the Quality Premium is make sure that commissioners are rewarded in the system for delivering the best possible results."

Referring to Dr Buckman's comments the Minister said: "I think that really is a caricature, a gross distortion of what we are trying to do here. What GP commissioning consortia will be rewarded for is improving the survival rates, improving the quality of care that is being delivered to their patients."

Mr Burstow confirmed that the Quality Premium payments would be paid to successful GP consortia by the new NHS Commissioning Board, funding would come from within existing NHS budgets, he said.

However he also commented this was not about incentivising cuts: "The Quality Innovation Productivity and Prevention programme which is running alongside these reforms is completely separate from the Quality Premium and to try to suggest that they are one and the same is really wrong."

Acknowledging the need to further engage with the BMA, Mr Burstow added: "It's very much about focusing commissioning activity on delivering world class results for patients: quality care, the best possible outcomes in terms of cancer survival rates and so on.

"And if the BMA haven't understood that at this stage we clearly need to talk with them further because we don't want them to be alarmed by this. We want them to be fully engaged in making sure these reforms deliver the best results for their patients."

Notes to Editors

Any quotes used should be attributed to Βι¶ΉΤΌΕΔ Radio 4's File On 4.

File On 4 is broadcast on Βι¶ΉΤΌΕΔ Radio 4 on Tuesdays, 8pm and is available as a podcast from .

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