Allocation: looking for a better way
I’m sure all new presidents must breathe a sigh of relief when they realize their term of office will not coincide with a time of potentially fractious negotiations with government. With the signing of the 2006 Agreement there promised to be 6 years of relative peace. This fact was mentioned to me on several occasions by past presidents who were not so fortunate.
However, what I, and they, had not counted on were the potential problems inherent in the “A” word—allocation. In the past few months I have received numerous communications from members, specialists and GPs alike on this subject—all of them dissatisfied with the process as well as the progress, or lack thereof.
Four years ago it was decided by a referendum of the membership that macroallocation be conducted between the SGP and SSPS, and following this decision the microallocation process for the specialist portion. This course has become somewhat more complicated by the increasing use of “targeted” funds, which in themselves are a type of allocation. Sorting out exactly who benefits and by how much can be complex and indeed was one factor that led to the recent court challenge to the arbitrator’s decision on macroallocation. This is of course now history, but has created significant bitterness and rancor.
Moving forward and improving the entire process is vital. A review of the negotiating process, which is mandatory, is now about to begin, to be followed by a thorough review of the allocation process. Fortunately, we have ample time left to get it right before the next round of negotiations.
From comments I have received there would seem to be two major areas of concern. First is the concept of having to vote on a negotiated package without knowing how the nontargeted increases would be split and how each section would fare at the micro level. Simply put, not everyone will see a 2.83%, 2%, 2%, 3% increase. The second concern is the length of time the entire process has taken.
The SGP no doubt has their own plan to distribute the annual increases in their fee guide. Unfortunately, with many fees being shared with other specialties this cannot be accomplished unilaterally.
The SSPS has developed a microallocation plan and by the time this article is published, the process either will have been endorsed by all sections or will have gone to arbitration. The bottom line, however, is that our members will likely not be seeing the benefit of a substantial part of the 2006 settlements until 2 years later.
So there has to be a better, more efficient, and less costly way. Members need to know, in advance, what they can expect from any negotiated settlement before they are asked to vote on the package. They also deserve a process that is guaranteed to deliver in a timely fashion. I hope the upcoming review will reveal a viable solution.
—Geoffrey Appleton, MB
BCMA President