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Is there a happy GP out there?

From Dr Barrie Davies, Tynewydd, Rhondda

Is there any GP out there who is really happy? Who honestly believes that the QOF has increased their enjoyment of patient contact?

How many boxes do we have to tick before actually asking what the problem may be? Medication review, annual bloods, is BP in target? And yes, tell me again, Mrs Jones, who actually gave you diazepam and why? What a load of tripe.

And no, just because Tesco opens late doesn't mean I should be expected to.

To add to it all, there has been all the recent negative press about GPs.

Can we please go back to having a little bit of common sense in all of this? I'm grateful that I'm nearing the end of my GP career; it's not a vocation I recognise any more.

• From Dr John D Leonard, Falkirk

The Government appears to be treating us, with regard to our pensions, in an offhand and uncaring manner. It would appear to be relying on the letter rather than the spirit of the law. It made what any reasonable person would take to be a binding agreement and then changed the rules. We need to respond in kind.

I do not propose anything illegal or damaging to the public and certainly nothing that would allow our standing with the general public to remotely approach their opinion of our politicians. Let us return to the letter of the law and how we might apply it to them:

• The Department of Work and Pensions sends us a five-page form to complete and send back to them in an official envelope. I suggest gathering these reports and filling them in diligently – let us say five reports containing 25 loose pages. Then mix the pages thoroughly and fill the five prepaid official envelopes with the completed reports in a completely haphazard way. Applying the letter of the law, we will have sent all the required information back to the Government.

• If someone is likely to be off work for three months, give them a Med 3 form for one week and any number of Med 5s dated the same day for the subsequent period.

• Write all these reports using obscure terms, for example: kinetic lactic acidosis of the myocardium (angina); hyperuricaemic crystalline deposits of the hallux (gout); vicissitudes of affect (manic depression); squamo-columner cell junction upper gastroenterological defect (hiatus hernia); chronic secretory failure of the islets of Langerhans (diabetes).

We are a very powerful group but traditionally have not had the will to do battle with the Government.

• From Dr Michael Caruana, Swanage, Dorset

What about comparing GPs' pensions with those of MPs, which are some of the most generous and are always uprated in excess of inflation?

Another important point is that doctors have no opportunity to start a superannuation scheme until they leave medical school at age 24 or 25, often with a large debt. This is always conveniently ignored.

• Some 100 GPs have now joined Ayrshire GP Dr Jim Beatson's protest against the cap on GPs' pensions. In their latest open letter to GPC chair Dr Hamish Meldrum, they demand answers to some tough questions

For many senior members of the profession, pension capping has dealt out gross injustice and profound insult in equal measure. Given our unified resolve and our strength of numbers (rising by the hour), many of us now feel that legal action will be unavoidable.

Our legal action will either be against the Government for an illegal breach of the GMS2 contract or against the GPC/ BMA for misrepresentation of the contract to the profession. We feel that vital information is being withheld from us by the GPC/BMA.

We demand clear and unequivocal responses from the GPC to these questions:

• Was the Government's unilateral decision to retrospectively cap GPs' pensions an illegal breach of the GMS2 contract or could such action be considered entirely legal under pre-existing 1995 legislation? It is hard to believe that Lord Warner, after threatening pension capping for 12 months, would have finally imposed it if they had thought for one moment that their action was illegal. Unless you can provide evidence to the contrary, we must conclude that pension capping was legal.

• At the negotiation stage of GMS2, wasn't the GPC/BMA fully aware of the potential threat posed by the 1995 legislation? Why otherwise did you state recently that 'our negotiators tried and failed to get the clause removed from the contract'? You also stated that the GPC 'accepted its inclusion on the understanding that it would only be used prospectively'. Was that 'understanding' in reality a calamitous misunderstanding, leading us to the inevitable conclusion that what the GPC/BMA believed had been agreed had, in legal terms, not been agreed? Does this not represent GPC/BMA negotiating incompetence? Alternatively, were the GPC/BMA negotiators incompetently advised by their own legal team?

We are unaware of any point during the GPC's roadshow in the run-up to the profession's vote on whether to accept the new contract, when any mention was made of the 1995 legislation or even the remote possibility of its application in dynamisation factor capping. Was this not a profoundly serious omission constituting misrepresentation of the contract to the profession?

We consider your promotion of a judicial review to be legally unsound as it cannot reverse the Government's pension capping decision.

• Other signatories include:

Dr Stuart Holms, Ayr, Ayrshire; Dr Jimmy Niblock, Ayr, Ayrshire;

Dr John Hawson, Windermere Cumbria;

Dr Brent Smith, Berwick-upon-Tweed, Northumberland;

Dr Robert Park, Shrewsbury, Shropshire;

Dr Dale Egerton, Liss, Hampshire;

Dr Duncan Darbishire, Ulverston, Cumbria;

Dr Roderick Shaw, Edinburgh Lothian;

Dr Roderick MacLeod, Shawlands, Glasgow;

Dr Michael Collins, Calver Derbyshire;

Dr William Phillips, Solihull West Midlands;

Dr Tony Shepheard, West Byfleet, Surrey;

Dr Charles Ogilvie, Falkirk, Stirlingshire;

Dr Robert Cumming, Lochranza, Isle of Arran

• Response from GPC chair

Dr Hamish Meldrum

Having responded directly to Dr Beatson in your columns twice already (25 January and

9 November 2006), there seems little value in restating my position and that of the GPC except to assure GPs we are acting on expert legal advice

in ways we believe are in the best interests of him and his colleagues.

Dr Beatson's anger is understandable and shared

by the rest of the profession including myself. His persistence in ignoring

my responses is not so understandable. I believe we are united in seeking the outcome of removing the cap.

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