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CAMHS won't see you now

Am I insane or is this contract even worse?

I write as a GP in his mid-50s who has been in practice for 25 years. Frequently, during my surgeries, I have to stop and ask my receptionists whether it is me or the patient who is barking mad. Their response is usually fairly non-committal.

The results of the latest efforts of our negotiators have me one stage nearer the Home For the Chronically Bewildered. I am reminded of Jack and the Beanstalk, where Jack sells the familly cow for beans (magic beans!).

I have to say I think I am not too badly paid for what I do. It would be nice if we did not have to waste our time doing home visits, except for the terminally ill, and could offer people reasonably lengthy appointments instead of having to keep part of the day free for aforementioned home visits. It would also be nice if our system of payment was simpler, and we did not have to waste our time filling in claims for every activity. It would be even nicer if the 1990 contract had never happened, and people's rights to decline cervical smears and so on had been respected.

It is apparent, however, that what our negotiators have dreamed up with the nice people from the Government makes the 1990 contract look positively benign and straightforward. After looking into the costs of opting out of night work, I have come to the conclusion that what looks initially tempting would, in fact, destroy us. I have no doubt that studying the costs of the rest of the contract would lead to a similar conclusion, if the figures were available.

Can somebody explain why, when the Government is in trouble over the state of the NHS, our negotiators were hoodwinked into this pile of nonsense?

Who asked them to negotiate a contract with vastly increased bureaucracy, and even more hoops to jump through?

Does past experience not show that, even if it were possible to earn more money with the new contract, after a year or two the Government would move the goalposts yet again, as they did after the 1990 contract, and we would be no better off, but saddled with ever more pointless data generation?

What is there in this contract that is going to entice young doctors into general practice?

What is there in this contract that is going to stop old duffers like me hanging up their stethoscope as soon as they can afford to?

Answers on a postcard to the Home For The Chronically Bewildered, please.

Dr Sandy Goudie


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