GP contract threatens student health service

April 18, 2003

University health centres could be forced to close unless significant changes are made to the proposed GP contract, according to the British Association of Health Services in Higher Education.

John Lethem, chair of the association, said: “Under the current figures, many student health practices will not remain viable, the opposite effect of the intention of the new contract negotiations.” Association members cover at least 800,000 students.

Dr Lethem said the proposed formula underestimated the workload involved in caring for students. He said it meant that GP practices with a large student population faced a significant drop in their income.

“Unfortunately, the proposed quality payments for many UK practices, including student health, do not sufficiently compensate for this fall in basic practice income,” he said.

“Uplift factors for high turnover of patients in the new formula are taken as an average for the area. But student health practices typically have 25 to 30 per cent turnover each year, way above the average of 10 to 15 per cent,” he added.

Dr Lethem said that the association had written to those negotiating the new contract but had received no reply to letters in the past six months. Letters to health secretary Alan Milburn and higher education minister Margaret Hodge had also elicited no response, he said.

The dedicated university health service that serves Imperial College London and the Royal College of Music is one of the most severely hit practices in the country. Its patient list has been seriously understimated in the new formula.

Its head, Irene Weinreb, said: “Our final list size was 61.5 per cent less than our actual one. We would certainly become unviable. The situation is very serious for us.”

The health service provides specialist mental health and sports services and liaises extensively with the colleges about students - not only in terms of their academic performance but also about issues such as expedition needs. It works with the student union, provides minor surgery and a full range of contraceptive services in-house.

“We meet all the National Health Service targets, we see patients for long appointments and as frequently as they need. It is ironic that a service such as ours, which provides levels of care that the government aspires to, will not survive the new contract,” Dr Weinreb said.

She said that it was particularly important to retain such dedicated health services at a time of widening access to “elite” institutions. It was “a move that will inevitably result in more emotional, academic and financial stress and the concomitant health problems for all parties involved”.

A spokesperson for the British Medical Association said: “The BMA has been negotiating a minimum practice income guarantee to ensure that all practices start under the new contract from a neutral position. Ministers in all four countries of the UK support the priniciple of the guarantee. We have been working on the details and will shortly produce a comprehensive guide for GPs.”

The spokesperson added that the issue of services for students would be dealt with specifically in the question-and-answer section of the guide.

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