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NHS Pay Modernisation: New Contracts for GP Services in England,
published yesterday by the Public Accounts Committee (PAC), estimates
the overspend at £1.8 billion between 2003/4 and 2005/6.

It says: 'The DoH believes the cost of the contract is now under closer
control and that by the end of 2008 it will have recovered any
overspend.'

However, the report shows that NHS chief executive David Nicholson put
the overspend at £400 million, rather than £1.8 billion.

It adds: 'There is evidence that the DoH reduced its estimation of
performance under the framework when budgeting for the increased cost
due to the MPIG.'

In evidence to the PAC in March, Mr Nicholson said: 'It's true that we
did overspend the amount of money available to us but in the past two
years we will have clawed the money back.'

The report blames the overspend on the extra costs of the quality
framework (£332 million), after practice performance exceeded
expectation, and the cost of allowing practices to opt out of 24-hour
responsibility (£182 million).

The report calls for piloting of major change so cost can be more
accurately predicted.

It also backs swapping MPIG for a 'redesigned global sum allocation to
move the money into areas of greatest need'.

The quality framework should be better aligned with national health
priorities and more outcomes-driven, it adds.

The report adds that in 2006/7 71 per cent of PCTs did not spend their
allocation for local enhanced services.

neil.durham@haymarket.com

- PCTs claw back up to £60,000 per practice, page 9.

GMS overspend

The Public Accounts Committee estimates £1.8bn overspend on the
GMS contract between 2003/4 and 2005/6

Source: Public Accounts Committee.