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Follow consultants' lead and reject our own new contract

Following the consultants' rejection of their proposed new contract GPs need to think carefully about what is on offer to us. Although the consultants stood to gain more money, they rejected the offer in order to retain some professional autonomy and maintain reasonable working hours.

Although most consultants work hours in excess of those contracted for, they did not want unsociable hours and management control to become part of their legally binding contract.

A worrying change to the GPs' new contract has not been flagged up by the BMA as a cause for concern.

This is the ability of the Secretary of State to impose a change to the contract unilaterally. Although a 12-week negotiating period will have to occur in some circumstances, this is likely only to delay the change rather than stop it. The BMA has tried to sell this as an improvement on the present situation, but that is not the case.

The present terms of service require GPs to provide 'all necessary and appropriate personal medical services of the type usually provided by GPs'.

This essentially allows GPs as a profession to decide what services they can reasonably provide. For example, we can legitimately refuse to start providing 48-hour access or STD clinics under the present contract. Although we often feel that we are powerless to resist change, the Secretary of State would have to go the Commons and the House of Lords to impose any significant change to our terms of service. This is by no means an easy task and can take a lot of parliamentary time.

In the new contract change could be imposed to our terms of service without any such resistance. Furthermore, even if the Secretary of State did not wish unilaterally to change what we do he could adjust the funding in such a way that we would effectively be forced to comply with his political agenda.

For example, funding for looking after cardiac patients could be reduced once we have achieved a good standard of care, as we are unlikely deliberately to let things slide. This money could then be offered for providing specialist services for drug addicts forcing GPs to comply in order to maintain income. Thus the same money could be moved around to make us work ever harder.

I think we should follow the consultants' lead and say No to a bit of extra money at the risk of running around faster and faster at the politicians' whim.

Dr Kaiser Chaudhri

Preston

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