GPs unimpressed by government concessions

Health minister relaxes demands but argues that health authorities should have more power to determine GP’s functions within the larger health service

General practitioners (GPs) remain opposed to a new revised law that the government presented to parliament yesterday that will set new basic conditions for GPs working for local health authorities.

The law was introduced following a year of fruitless negotiations between GPs and the regional health authorities, Danske Regioner. The GPs' union, PLO, argues that Danske Regioner want too much control over how GPs run their clinics, while the regions want GPs to become more integrated into the health service by providing more data about their patients and a wider variety of care.

The health minister, Astrid Krag (Socialistisk Folkeparti), presented the revised law yesterday, and while it accommodated some of the concerns of GPs, Krag argued that certain fundamental changes were necessary.

“It’s important the local health authorities and councils can plan the roles of GPs as part of a holistic health service but this will now take place with the co-operation of doctors,” Krag wrote in a press release about the decision to allow three GPS to be represented on regional health planning boards after GPs were initially not included.

“I want to do away with any misunderstanding,” Krag added. “The government wants to expand the current system of GPs while also retaining its core. I don’t want to micro-manage the everyday work of doctors, and of course PLO and the regional health authorities will have to negotiate salaries and working plans.”

Once the law is passed, it will form the starting point for future negotiations between GPs and health regions for forming a new deal that will begin in September 2014. The new deal will allow GPs who own their own private practices to keep their service contracts with the government and provide their patients with free health care – without it patients will have to pay to see their doctor.

Before the government announced its concessions in the new law, which include allowing doctors on planning boards and making no fixed demands about opening and phone consultation times, around 94 percent of GPs said they were prepared to hand back their service numbers, effectively leaving the public system, if the law passed.

And at a conference in Odense yesterday, several thousand GPs voiced their continued opposition to the government’s plan to update their basic working contracts.

“The law is completely unacceptable as it currently stands,” PLO's chairman, Henrik Dibbern, told Politiken newspaper. “They are taking the wrong approach. Forcing legislation upon us the absolute wrong method.”

The government argues, however, that GPs need to contribute more to the total health service by providing more data about the types of patients and illnesses they treat, and by offering a greater range of services such as home visits to elderly patients.

The law will have no impact on the right for GPs to negotiate with their local health authorities about how much the services they provide should cost. The government does, however, want to allow regions greater insight into how doctors spend their money after concerns were raised by the state auditor, Rigsrevisoren, that GPs are not in control of their spending.