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After a difficult year in 2006 for general practice, we ask GPs what they think 2007 may have in store for them

GPs forecast a year of uncertainty

2006 was a tough year for GPs. No pay rise, a tougher quality framework, more work being loaded on to practices and the pensions cap.

So what do GPs think 2007 will bring? Gwyn Dixon found precious little optimism.

• Dr Abayomi McEwen, Buckhurst Hill, Essex

'Uncertainty. We don't really know how we're going to practise, we don't know which of my educational jobs I will still have, due to NHS cuts, and the list goes on.

'Unending change will be the theme.'

• Dr Barry Silvert, Bolton

'I have fairly gloomy forebodings. I think there's going to be more political interference and I think the politicians don't like GPs all that much.

'I think the issue of the pensions cap is only going to grow.'

• Dr Michael Crawford, Dromara, Co. Down

'The evolving quality and outcomes framework will be more difficult than in the previous two years and we expect it to get worse.

'I hope to provide a good standard of care and keep the patients as healthy, wealthy and well as possible.'

• Dr Hugh Taylor, Epping Forest, Essex

'All PCTs have been re-organised and, until people get their feet under the table, it will be a problem.

'We've also had a real problem with our premises. They're 30 years old and, while good in their time, they are now no longer suitable. Our concern is to improve them in 2007.'

• Dr Raja Dandapat, west London (above)

'Due to practice-based commissioning, we are now restricted in our referrals to hospitals.

'Also, there are more demands and pressure on me and pressure on all the practice staff to complete the quality framework to obtain enough points to be able to earn a decent income.'

• Dr Julie Parsons, Derby

'Practice-based commissioning is a hot topic locally as we work to save on hospital referrals.

The workload seems to be increasing.

'We have the new contract to keep up with, particularly in depression and mental health.'

• Dr Andrew Dayani, Taunton, Somerset

'For me it will be as interesting as it always is, because I get to work with patients.

'But as a profession I think we stand to be blamed for the problems of the NHS; there will be added responsibility without the accompanying authority.'

• Dr Agnelo Fernandes, Croydon, Surrey

'I would warn GPs not to get too negative by reading the press. I'm optimistic this will be the year of greatest opportunity for GPs for a decade as practice-based commissioning comes online.

'If you're doing the right thing clinically, with a good referral policy, then practice-based commissioning shouldn't be a problem.'

• Dr Beth McCarron-Nash, Honiton, Devon

'I'm just becoming a partner at our practice, so it's a year of huge change for me. But at the moment is doesn't look like a happy new year for GPs in general. I worry about my older colleagues with pensions and I think the QOF will be a problem.

'I think morale is a huge issue across the board.'

• Dr Belinda Brewer, Chichester, West Sussex

'Patient details are going to be put onto the spine but once

patients are on, it's going to

be very difficult for them to get off it.

'That will be a big issue in 2007 and many GPs are concerned about confidentiality. I'm uncomfortable with it. I'm not sure about it at all.'

• Dr Robbie Coull, Strachur, Argyll

'One of the biggest issues is going to be the increasing divide between Scotland and England as privatisation picks up in England. I think we personally will have a good year financially, but the continuing decline of the NHS will cause increased anxiety and stress in general.'

• Dr Anila Reddy, sessional GP in London (above)

'I see a problem with the Government's view that 19 out of 20 patients will be able to be diagnosed by nurse practitioners. Nurses are not being fully trained and do not have proper medico-legal support.

'If someone extended the roles of GPs to allow them to

do amputations, then you'd expect them to have the requisite training.'

• Dr Stuart Findlay, Haddenham, Cambridgeshire

'Personally, we've spent a year searching for replacement partners. It has been a problem to find people wanting to buy into a partnership.

'We're not happy the Government has cut our income by increasing the QOF points we require. We don't like playing the numbers game.'

• Dr Andrew Dearden, GPC Wales chair

'We don't want to see a situation where competition becomes part of the NHS or that it moves more towards privatisation. Patients and GPs want the NHS to stay in public hands.'

• Dr Mark Hunt, Frome, Somerset

'We will see a tightening of the contract, with the balance swinging towards PCTs. With more local APMS contracts coming up, PCTs will have a more active stipulating role. GPs will also have to tighten the screw on their costs.

'We're optimistic and exploring opportunities to expand.'

• Dr Ann Smallridge, Salford, Greater Manchester

'It will be the make-or-break year for practice-based commissioning. Also, extended opening hours will cause more pressure and GPs will have to deal with this one way or another.

'Personally, I'm very optimistic because for us there are lots of new challenges.'

• Dr Ranjit Gill, Stockport

'For us, to make practice-based commissioning deliver is opportunity A.

'B is managing the relationship between general practice and PCTs.'

• Dr Nigel Dickson, Portswood, Hampshire

'I hope they get Choose and Book right. It's a very good idea, but the current system is a complete shambles. If implemented the way it was originally planned, it would make life easier.'

• Dr Akram Khan, Bradford

'The QOF is going to feature more. I don't think it will be positive as GPs will struggle to do the same amount of work and maintain the same wage.

'The quality will improve if we actually have the funding to go along with it.'

• Dr Mary Hawking, Dunstable, Bedfordshire (above)

'I'm going half-time to do a post-graduate course in health informatics. I think we will see a lot of conflict over the Government's inability to stick to contracts – like the pensions debacle.

'I also foresee problems with the NHS Care Record.'

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