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At the heart of general practice since 1960

It's the bill that's extreme, not its critics

Professor Steve Field says of the listening exercise he leads: 'What we've got to do is take some of the extreme views out'

These reforms in their entirety are ‘extreme'. Since they were first promoted, many prominent organisations have commented that they are too far, too fast. I am in favour of GPs having a greater say in commissioning, but I am totally opposed to these reforms, and would rather see greater GP representation on PCT boards rather than the complete abolition of PCTs and GPs on consortia spending hours away from patients.

The reforms are already causing chaos, with essential roles being lost at PCTs, nobody to take over and a vacuum being created. Expertise and experience of managers is being lost as they look for work elsewhere. Where will a sufficient number of GPs find the time for commissioning for consortia to work?

Most GPs I know are already over-worked, and morale is falling over the reforms, revalidation and the assault on pensions. The reforms come at the same time that we as clinicians are expected to find £20bn of efficiency savings.

Patients are complaining that operations that were previously routinely funded are no longer being funded, and patients who can afford to are being forced to go private.

Those who cannot afford private cover just have to put up with lengthening waiting lists and no treatment for their problems, and it is the poorest and most vulnerable who will suffer the most.

I am now expected to learn complex lists of criteria that must be met before I can refer for a wide range of conditions. I work part-time as a locum in three different PCTs, all with differing structures and referral criteria and only yesterday, the practice where I work as a salaried GP the rest of the time, received a complaint from a patient unhappy about the referral criteria for tonsillectomy.

It is a complete waste of our time having to deal with complaints like that. I don't regard my views, or those of anyone else who opposes these reforms, as extreme; it is the reforms themselves which are extreme.

From Dr John Pike, Bristol, via pulsetoday.co.uk

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