Family doctors in England are working less, but paid more after the introduction of a new contract "failed to live up to expectations", MPs said.
Family doctors in England are working less, but paid more after the introduction of a new contract "failed to live up to expectations", MPs said.
The Commons' Public Accounts Committee report found that the 2004 deal led to fall in productivity and working hours, while pay for GP partners rocketed.
The Commons' Public Accounts Committee report found that the 2004 deal led to fall in productivity and working hours, while pay for GP partners rocketed.
But the MPs also pointed it out it has led to a rise in the number of GPs and a greater variety of services.
But the MPs also pointed it out it has led to a rise in the number of GPs and a greater variety of services.
Ministers said they had already started to address the issues.
Ministers said they had already started to address the issues.
The report looked at the impact of the contract in England.
The report looked at the impact of the contract in England.
While the deal applied to all of the doctors in the UK, many of the problems have been most marked in England.
While the deal applied to all of the doctors in the UK, many of the problems have been most marked in England.
Much of the criticism in this report is based on an out-of-date understanding of the current situation Dr Laurence Buckman, of the British Medical Association
Much of the criticism in this report is based on an out-of-date understanding of the current situation Dr Laurence Buckman, of the British Medical Association
The report said over the first three years, the contract cost £1.8bn more than expected.
The report said over the first three years, the contract cost £1.8bn more than expected.
This was blamed on the government for underestimating the cost of providing out-of-hours care - GPs were allowed to opt out of weekend and night care under the terms of the deal - and the better than expected performance of doctors.
This was blamed on the government for underestimating the cost of providing out-of-hours care - GPs were allowed to opt out of weekend and night care under the terms of the deal - and the better than expected performance of doctors.
The contract was structured so that about a third of doctor pay was linked to performance.
The contract was structured so that about a third of doctor pay was linked to performance.
But since the changes were made GPs have hit well over 90% of their targets. The report said the targets had been "too easy".
But since the changes were made GPs have hit well over 90% of their targets. The report said the targets had been "too easy".
It also pointed out that pay for GP partners had shot up by 58% to £114,000 a year, although much smaller rises had been seen for salaried GPs and nurses.
It also pointed out that pay for GP partners had shot up by 58% to £114,000 a year, although much smaller rises had been seen for salaried GPs and nurses.
This happened over a period when GPs started working fewer hours - 36.3 a week compared to 43.1 in the 1990s - and productivity fell.
This happened over a period when GPs started working fewer hours - 36.3 a week compared to 43.1 in the 1990s - and productivity fell.
The government has already responded to such trends by rewriting the GP contract this year to encourage surgeries to offer weekend or evening opening. So far nearly half have done so.
The government has already responded to such trends by rewriting the GP contract this year to encourage surgeries to offer weekend or evening opening. So far nearly half have done so.
But the report did highlight some positive impacts with patients now being guaranteed appointments within 48 hours - although this had perversely resulted in some patients struggling to book appointments in advance.
But the report did highlight some positive impacts with patients now being guaranteed appointments within 48 hours - although this had perversely resulted in some patients struggling to book appointments in advance.
The cross-party group of MPs also said GP consultations had become longer as nurses had taken on extra responsibilities including asthma and diabetes reviews.
The cross-party group of MPs also said GP consultations had become longer as nurses had taken on extra responsibilities including asthma and diabetes reviews.
This also meant family doctors were offering a wider range of services - in recent years they have started taking on care traditionally done in hospitals, such as minor surgery.
This also meant family doctors were offering a wider range of services - in recent years they have started taking on care traditionally done in hospitals, such as minor surgery.
And the contract also seems to have brought more doctors into the profession with an extra 4,000 being employed since the contract started, bringing the workforce to over 33,000.
And the contract also seems to have brought more doctors into the profession with an extra 4,000 being employed since the contract started, bringing the workforce to over 33,000.
'Pay is burgeoning'
'Pay is burgeoning'
Nonetheless, committee chairman Edward Leigh said: "The new contract has so far failed to live up to expectations.
Nonetheless, committee chairman Edward Leigh said: "The new contract has so far failed to live up to expectations.
"Partners in GP practices are now putting in less time and their productivity has decreased. Only their pay is burgeoning."
"Partners in GP practices are now putting in less time and their productivity has decreased. Only their pay is burgeoning."
Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said: "Much of the criticism in this report is based on an out-of-date understanding of the current situation.
Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said: "Much of the criticism in this report is based on an out-of-date understanding of the current situation.
"GP practices have taken on additional work since the original contract was agreed and practice income has been frozen."
"GP practices have taken on additional work since the original contract was agreed and practice income has been frozen."
Health minister Ben Bradshaw said moves had already started to improve services, citing the longer opening hours.
Health minister Ben Bradshaw said moves had already started to improve services, citing the longer opening hours.
"We continue to look constantly at ways to improve the contract and the report will help inform further improvements."
"We continue to look constantly at ways to improve the contract and the report will help inform further improvements."
Are you affected by the issues in this story? Send your comments and experiences using the form below.
In most cases a selection of your comments will be published, displaying your name and location unless you state otherwise in the box below.
