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Hopes and fears

Will the contract mean a long-awaited shot in the arm for general practice or the beginning of the end? GPs spoke to Jo Carlowe of their hopes and fears

Dr Gillian Braunold a GP in London

"I have both hopes and fears. I hope the contract will help us to concentrate on the areas that we want to focus on and reward us for doing that. But I fear it will not switch around the problems with recruitment and retention and that some practices do not know the extent of the computer burden in front of them."

Dr Gerald Spence a GP in Glasgow

"I am completely confused and disappointed about this contract. The problems with superannuation and quality payments have not been addressed. The money we have been told we will get will be reduced by 20 per cent as we have to pay our own superannuation payment."

Dr Shah-naz Whitear

a GP in

Suffolk

"Although I welcome a change and feel things have to progress to improve patient care, I fear that collecting large amounts of data on a computer will not necessarily improve care or in any way make us better doctors. It could mean losing that personal touch, and I think this would be very sad indeed."

Dr Richard Vautrey a GP in Leeds

"I am essentially optimistic. I don't think it will be until April 2005 that we will see the full fruits of the contract but I have no doubt practices will rise to the challenge and will reap the rewards. I am looking forward to seeing the high standards of clinical care that we have been offering for years at last being rewarded."

Dr Helen Tattersfield a GP in London

"I think if I weren't a PMS GP I would be extremely depressed. We are a small practice and even though we are high performers, I don't think

we would get enough money to keep going. I don't

think there is sufficient

money in the pot for small practices."

Dr Unnati Misra

a GP in Birmingham

"They are dangling a carrot in front of GPs but the targets are absolutely unrealistic in

my opinion. The only way people can meet them is to fiddle the figures. I am a salaried GP and I have to

say that the contract does nothing for salaried GPs

who are devoted to their work."

Dr Richard Fitton a GP in Derbyshire

"I think the new contract is excellent for patients, being based on evidence-based medicine. It also allows for choice. But as a singlehander I will need to opt out of out-of-hours which is a shame as I carry a phone at all times and help with triage and advice."

Dr Abayomi McEwen a portfolio GP, working three or four clinical sessions per week, in Essex

"The contract takes a population approach. We have to get all different diseases below certain targets with this linked to income. It could mean the individual voice of the patient gets lost. It saddens me that the concept of being a family doctor will be replaced by a conveyor belt approach to patient care."

Dr Peter Fink

a GP in Manchester

"I feel very neutral about the contract ­ almost disinterested. The contract and enhanced services are a non-starter until April 2005 when 'payment by results' comes in. Only then might PCOs be able to find some money for primary care and GPs be able to participate in interesting enhanced services."

Dr Ruth Livingstone a GP in Lincolnshire

"I hope the contract will make general practice more attractive to young GPs who will come in as partners, salaried GPs and locums. I think it will achieve this because of the out-of-hours opt-out."

Dr Vasant Manudhane

a GP in Stoke-on-Trent

"My fear is that whereas previously we knew money would come from the area health authority and there would be no discrimination, now we have to negotiate

for this ourselves. Those of us who have been in general practice for 20-30 years are not trained to know how to do this."

Dr Aneez Esmail

a GP academic in Manchester

"My biggest worry is the potential for an increase in bureaucracy. It is important to measure outcomes but I think the amount of measurement required is really going to be excessive. The theory is that with good IT systems then much of the data required

will be collected automatically, but promises made for IT

are almost always greater

than the actual benefits delivered."

Dr Claire Pedder

a GP in Edinburgh

"We are a PMS practice

so we are slightly protected from the initial impact of the contract, but I have fears over funding. It is all very well negotiating areas where we previously were not paid if the money for enhanced services is really available. But there is a big question-mark over whether PCTs can actually afford all these bells and whistles."

Dr Nick Raithatha a GP in Norwich

"My main concern is that the contract via the quality markers is driving us towards what I call 'protocol' medicine whose aim is to achieve easily measurable targets. In this new world patient-centred holistic care will be lost."

Dr Robert Morley

a GP in Birmingham

"My fear is that this is supposed to be a contract that allows us to limit workload but I see precious little evidence that this will be possible. Even if we have the income to recruit staff there are no guarantees about staff maternity or sickness pay. I am very sceptical about whether this supposed renaissance in general practice will really come about."

Dr Gillian Braunold a GP in London

"I have both hopes and fears. I hope the contract will help us to concentrate on the areas that we want to focus on and reward us for doing that. But I fear it will not switch around the problems with recruitment and retention and that some practices do not know the extent of the computer burden in front of them."

Dr Gerald Spence a GP in Glasgow

"I am completely confused and disappointed about this contract. The problems with superannuation and quality payments have not been addressed. The money we have been told we will get will be reduced by 20 per cent as we have to pay our own superannuation payment."

Dr Shah-naz Whitear

a GP in

Suffolk

"Although I welcome a change and feel things have to progress to improve patient care, I fear that collecting large amounts of data on a computer will not necessarily improve care or in any way make us better doctors. It could mean losing that personal touch, and I think this would be very sad indeed."

Dr Richard Vautrey a GP in Leeds

"I am essentially optimistic. I don't think it will be until April 2005 that we will see the full fruits of the contract but I have no doubt practices will rise to the challenge and will reap the rewards. I am looking forward to seeing the high standards of clinical care that we have been offering for years at last being rewarded."

Dr Helen Tattersfield a GP in London

"I think if I weren't a PMS GP I would be extremely depressed. We are a small practice and even though we are high performers, I don't think

we would get enough money to keep going. I don't

think there is sufficient

money in the pot for small practices."

Dr Unnati Misra

a GP in Birmingham

"They are dangling a carrot in front of GPs but the targets are absolutely unrealistic in

my opinion. The only way people can meet them is to fiddle the figures. I am a salaried GP and I have to

say that the contract does nothing for salaried GPs

who are devoted to their work."

Dr Richard Fitton a GP in Derbyshire

"I think the new contract is excellent for patients, being based on evidence-based medicine. It also allows for choice. But as a singlehander I will need to opt out of out-of-hours which is a shame as I carry a phone at all times and help with triage and advice."

Dr Abayomi McEwen a portfolio GP, working three or four clinical sessions per week, in Essex

"The contract takes a population approach. We have to get all different diseases below certain targets with this linked to income. It could mean the individual voice of the patient gets lost. It saddens me that the concept of being a family doctor will be replaced by a conveyor belt approach to patient care."

Dr Peter Fink

a GP in Manchester

"I feel very neutral about the contract ­ almost disinterested. The contract and enhanced services are a non-starter until April 2005 when 'payment by results' comes in. Only then might PCOs be able to find some money for primary care and GPs be able to participate in interesting enhanced services."

Dr Ruth Livingstone a GP in Lincolnshire

"I hope the contract will make general practice more attractive to young GPs who will come in as partners, salaried GPs and locums. I think it will achieve this because of the out-of-hours opt-out."

Dr Vasant Manudhane

a GP in Stoke-on-Trent

"My fear is that whereas previously we knew money would come from the area health authority and there would be no discrimination, now we have to negotiate

for this ourselves. Those of us who have been in general practice for 20-30 years are not trained to know how to do this."

Dr Aneez Esmail

a GP academic in Manchester

"My biggest worry is the potential for an increase in bureaucracy. It is important to measure outcomes but I think the amount of measurement required is really going to be excessive. The theory is that with good IT systems then much of the data required

will be collected automatically, but promises made for IT

are almost always greater

than the actual benefits delivered."

Dr Claire Pedder

a GP in Edinburgh

"We are a PMS practice

so we are slightly protected from the initial impact of the contract, but I have fears over funding. It is all very well negotiating areas where we previously were not paid if the money for enhanced services is really available. But there is a big question-mark over whether PCTs can actually afford all these bells and whistles."

Dr Nick Raithatha a GP in Norwich

"My main concern is that the contract via the quality markers is driving us towards what I call 'protocol' medicine whose aim is to achieve easily measurable targets. In this new world patient-centred holistic care will be lost."

Dr Robert Morley

a GP in Birmingham

"My fear is that this is supposed to be a contract that allows us to limit workload but I see precious little evidence that this will be possible. Even if we have the income to recruit staff there are no guarantees about staff maternity or sickness pay. I am very sceptical about whether this supposed renaissance in general practice will really come about."

Dr Gillian Braunold a GP in London

"I have both hopes and fears. I hope the contract will help us to concentrate on the areas that we want to focus on and reward us for doing that. But I fear it will not switch around the problems with recruitment and retention and that some practices do not know the extent of the computer burden in front of them."

Dr Gerald Spence a GP in Glasgow

"I am completely confused and disappointed about this contract. The problems with superannuation and quality payments have not been addressed. The money we have been told we will get will be reduced by 20 per cent as we have to pay our own superannuation payment."

Dr Shah-naz Whitear

a GP in

Suffolk

"Although I welcome a change and feel things have to progress to improve patient care, I fear that collecting large amounts of data on a computer will not necessarily improve care or in any way make us better doctors. It could mean losing that personal touch, and I think this would be very sad indeed."

Dr Richard Vautrey a GP in Leeds

"I am essentially optimistic. I don't think it will be until April 2005 that we will see the full fruits of the contract but I have no doubt practices will rise to the challenge and will reap the rewards. I am looking forward to seeing the high standards of clinical care that we have been offering for years at last being rewarded."

Dr Helen Tattersfield a GP in London

"I think if I weren't a PMS GP I would be extremely depressed. We are a small practice and even though we are high performers, I don't think

we would get enough money to keep going. I don't

think there is sufficient

money in the pot for small practices."

Dr Unnati Misra

a GP in Birmingham

"They are dangling a carrot in front of GPs but the targets are absolutely unrealistic in

my opinion. The only way people can meet them is to fiddle the figures. I am a salaried GP and I have to

say that the contract does nothing for salaried GPs

who are devoted to their work."

Dr Richard Fitton a GP in Derbyshire

"I think the new contract is excellent for patients, being based on evidence-based medicine. It also allows for choice. But as a singlehander I will need to opt out of out-of-hours which is a shame as I carry a phone at all times and help with triage and advice."

Dr Abayomi McEwen a portfolio GP, working three or four clinical sessions per week, in Essex

"The contract takes a population approach. We have to get all different diseases below certain targets with this linked to income. It could mean the individual voice of the patient gets lost. It saddens me that the concept of being a family doctor will be replaced by a conveyor belt approach to patient care."

Dr Peter Fink

a GP in Manchester

"I feel very neutral about the contract ­ almost disinterested. The contract and enhanced services are a non-starter until April 2005 when 'payment by results' comes in. Only then might PCOs be able to find some money for primary care and GPs be able to participate in interesting enhanced services."

Dr Ruth Livingstone a GP in Lincolnshire

"I hope the contract will make general practice more attractive to young GPs who will come in as partners, salaried GPs and locums. I think it will achieve this because of the out-of-hours opt-out."

Dr Vasant Manudhane

a GP in Stoke-on-Trent

"My fear is that whereas previously we knew money would come from the area health authority and there would be no discrimination, now we have to negotiate

for this ourselves. Those of us who have been in general practice for 20-30 years are not trained to know how to do this."

Dr Aneez Esmail

a GP academic in Manchester

"My biggest worry is the potential for an increase in bureaucracy. It is important to measure outcomes but I think the amount of measurement required is really going to be excessive. The theory is that with good IT systems then much of the data required

will be collected automatically, but promises made for IT

are almost always greater

than the actual benefits delivered."

Dr Claire Pedder

a GP in Edinburgh

"We are a PMS practice

so we are slightly protected from the initial impact of the contract, but I have fears over funding. It is all very well negotiating areas where we previously were not paid if the money for enhanced services is really available. But there is a big question-mark over whether PCTs can actually afford all these bells and whistles."

Dr Nick Raithatha a GP in Norwich

"My main concern is that the contract via the quality markers is driving us towards what I call 'protocol' medicine whose aim is to achieve easily measurable targets. In this new world patient-centred holistic care will be lost."

Dr Robert Morley

a GP in Birmingham

"My fear is that this is supposed to be a contract that allows us to limit workload but I see precious little evidence that this will be possible. Even if we have the income to recruit staff there are no guarantees about staff maternity or sickness pay. I am very sceptical about whether this supposed renaissance in general practice will really come about."

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