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Independents' Day

BMA's contract climbdown spells end of our NHS careers

The latest U-turn by the BMA could mean the end of my NHS career ('GP leaders climb down in contract dispute'). The BMA may feel this battle over misuse of the 'unilateral change in contract' is best not fought yet. We at least have a bit of high ground now. With the Darzi centres coming in the next 12 months and private enterprise winning most of the APMS contracts, we will have lost any bargaining power as replacements will be ready and waiting.

I took over a failing singlehanded practice shortly after the introduction of nGMS so my livelihood is completely dependent on the MPIG. Indeed, without the MPIG I could not have considered taking on the practice. This practice exists solely because of patient choice. Our PCT is putting out to tender three new practices, one in our immediate vicinity.

The Government has already made it clear it will remove the MPIG as soon as it can. Soon I will face two choices: go bankrupt or leave. My patients will then have less choice of where they receive their primary care.

By not fighting, the BMA has allowed the Government to strengthen its position to one of complete unassailability.

I cannot be the only small practice in England that faces such a stark future, can I?
From Dr Ian Maclure, Mossley, Greater Manchester

Why am I not surprised at the cave-in by the BMA in the negotiations over extended hours? One cannot be too hard on the negotiators. After all, they are first and foremost working doctors who do that job because you or I won't, and are not political professionals, unlike their adversaries.

But what has the BMA ever done for us? In the 1960s it made a mess of the Glanville case, concerning remuneration of doctors' spouses (doctors, unlike MPs, were not allowed to employ family members). It capitulated over the 1991 contract under Kenneth Clarke (who abused doctors over the size of their wallets). It negotiated a derisory fee of £50 maximum for access to patients' records for solicitors. And the relative success of the 2001 contract was more by good luck than negotiating skill, because the Government got its sums wrong.

So never mind mass resignation from the NHS, what about mass resignation from the BMA instead? It really is good money down the drain.
From Dr T E Kenny, St Helens, Merseyside

I am astounded at the cowardice of the BMA in climbing down to the demands of the Government over extra hours - even before it has balloted grassroots GPs. A jellyfish has more spine than our negotiators at the GPC.

Don't they realise that now they have climbed down, during the next 12 months there will be further attacks on the 2004 contract and the next ultimatum will be for GPs to take back responsibility for out-of-hours care?

Thank God I have retired and now work part-time!
From Dr Martin Seely, Worsley, Manchester

I would certainly support your correspondent, dubbed Spleen, in the plan for an alternative trade union ('I'm willing to lead split from the BMA').

Our leaders should tell the Government that if it continues with its dictatorial state, GPs will withdraw their labour on a given Friday and return on the following Monday to a contract that is acceptable to them. In the meantime, the BMA should be drawing up the framework of this contract, which will be dictated by GPs for the good of their patients.

If we do it now, the Government has nobody with whom to replace us, and should have caved in by 10am on the Monday. The dentists did it, so why can't we?

If ministers can behave in the unprincipled and underhand way that they have, unilaterally changing supposedly binding contracts, then it should not be beyond the wit of our leaders to play them at their own game and by the only rules they seem to understand. If the BMA can't do that, then I'm with Spleen.

From Dr Patrick Milroy, Frodsham, Cheshire

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