Gareth Iacobucci talks to GPs about how they have coped with another tumultuous year for the profession
After a year of QOF changes, an overhaul of medical regulation and a cap on pensions, we asked GPs about the highs and lows of 2006 – and what they wanted from health secretary Patricia Hewitt for Christmas.
• Dr Phil Brookes, a GP in Newcastle
'There's an increasing strain between balancing patient expectations with services available and I don't see it improving.
'The pressure to privatise
services could depersonalise the doctor-patient relationship that is central to general
• Dr Mary Church, a GP in Glasgow and a former GP negotiator
'There were problems in trying to implement CKD screening, but it will prevent disease in a significant number of people.
'I'm worried about the trend of moving work towards less-qualified people, and I don't think GP skills are suitably appreciated by the politicians.
'I'm glad I'm working in Scotland and not in England.'
• Dr Paul Heenan, a GP in Clapham, south London
'It's been challenging this year because of the QOF targets, which seem to keep changing all the time.
I'm also concerned about what's happening with GPs' pensions, and what seems to be the wholesale sell-off of parts of the NHS to the private sector. GPs will need to respond to that.'
• Dr Andrew Dearden, a GP in Cardiff and chair of the BMA
'I'm not overwhelmed with foreboding. We've preserved the right to retire at 60 and the dynamising factors have been a success. But the Government has shown we can't really trust it – which will make a big difference to the way we negotiate.'
• Dr David Bellamy, a GPSI in respiratory medicine in Bournemouth
'It's been an enjoyable year seeing patients, but less enjoyable spending more time playing target-driven tick-box medicine.
'Some areas of the QOF don't seem to be driven by good clinical practice.'
• Dr Fiona Cornish, a GP in Cambridge
Our PCT is massively in debt and the problems from this year are going to persist if they can't reverse the problem. We're being told not to refer or admit, and the challenge at the moment is to find out how to still provide a good service.'
• Dr Gill Beck, a GP in Aylesbury, Hampshire
'We've been drowned in paperwork this year. Our premises were found not fit for purpose, but there's no investment and it's been a very long process.
'I'm still glad to be a GP but it's all uncertain at the moment so it's very difficult to have a vision. The Government isn't supporting general practice, but I think we will survive despite it.'
• Dr Martin Breach, a GP in Haydock, Lancashire
'The biggest challenge has been trying to get to grips with practice-based commissioning, and I think this will remain the case next year. I think the future is bright, but we need to allow the changes to bed in.'
• Dr Suraj Sharma, a GP in Liverpool
'We've been adapting to new, very fast changes. Quality points have been challenging, as has dealing with the media perception that GPs are fat cats.
The biggest challenge for next year is commissioning.
'We are a very privileged country in terms of health care. The future will be bright as long as we adapt to the changes.'
And a message for Hewitt...
Dr Dearden 'Stand up to the Treasury and tell them patients deserve investment, not cuts.'
Dr Bellamy 'A major rethink is needed. The current system is causing a rift between primary and secondary care.'
Dr Sharma 'Please be more pragmatic and listen to GPs, we are the frontline. Changes need to be made, but slow down.'
Dr Beck 'Let the NHS bed down and sort itself out before you waste any more money.'
Dr Brookes 'You're hopeless, resign.'