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Just say no to the Government’s deal while you still can

Here we go again. Extended opening this time. I see Ben Bradshaw is saying the BMA should not put the interests of its members first. Er… sorry?

I thought the job of a trade union was to represent its members above all else. Nobody else is going to!

What is more, almost every other agency has spent the past few years repeatedly doctor-bashing. What will it take to shake the namby-pamby, do-whatever-I'm-told members of our profession and those who will do anything for the price of a school fee into realising this is another very big nail in the coffin of their career?

Next year it will be opening every night and the year after it will be opening all night.

Eventually, we will resign and the Government will get its way and replace us with private sector nurses with impressive-looking computers and gadgets to make the punters feel they are getting value for money. Can't you see this?

I am sick of doctors failing to respect themselves enough to put their collective feet down and say enough is enough. They huddle in little groups and moan about their working conditions and then do nothing. There are tens of thousands of GPs in this country. The Government can't do without us all.

We need a proper trade union and representatives with teeth and who are not afraid to use them. Vote with your feet. Just say no - while you still can.

From Dr J Wotherspoon, Merseyside

Recent moves by the Government to impose extra hours on GPs or threaten heavy financial penalties have uncovered the BMA's naivety and ineptitude in negotiating the 2004 contract.

At the time the contract was being negotiated there were warnings of the risk of allowing the Government unilateral powers to change it. There were also concerns that the QOF could be manipulated to meet political priorities and make GPs work harder to maintain their income.

But both the BMA and GPs were seduced by the promise of a short-term increase in income, generous pension rises, the loss of out-of-hours responsibility and a supposedly evidence-based QOF. These gains have gradually been eroded through pay freezes, the pension cap, the planned increases in working hours and the manipulation of QOF points at the Government's whim. It also now appears that the MPIG can be phased out and isn't available in perpetuity as promised.

At least before 2004 out-of-hours work could be delegated to co-operatives by most GPs, whereas now we face having to provide an in-hours level of service at evenings and weekends. GPC leaders are said to be astonished by the Government's actions and not to have experienced anything like it in more than 20 years.

Dr Laurence Buckman is accusing the Government of holding a gun to our heads.

Perhaps the negotiators have missed the point - that it was their naive negotiations that gave ministers that gun.

From Dr Kaiser Chaudhri, Preston, Lancashire

Last year was an annus horribilis for GPs and 2008 looks set to be even worse. We have been subjected to a barrage of denigrating spin by the Government - a campaign of centrally led propaganda to undermine our profession.

In nearly 20 years of general practice, this is the lowest morale I have experienced.

We are being dealt with in an utterly disgusting manner by the Government and consequently by the spin-driven press. We have featured continuously on radio and TV programmes all year for apparently working fewer hours and earning huge salaries. All of this is negative, inaccurate and wearying.

We work hard enough between the already uncivil hours of 8am and 6.30pm, 84% of the population is satisfied with access, yet still the Government is unhealthily obsessed with extending opening hours until 8pm. If ministers thought this was so vital, new cash should have been made available to fund an extended hours LES, as a voluntary addition dependent on unusual local needs.

The Government's gun-barrel approach, with the threat of imposing a pay-cutting contract, over an issue that has nothing to do with good clinical care of patients, but all to do with perceived political gains and the wishes of a few well-to-do commuters, is disgraceful, disrespectful, and shows how little the Government values GPs.

From Dr Anthony DeWeever, Manchester

As a full-time GP I am disillusioned by the Government's approach to the NHS and to primary care in particular. I cannot see the clinical need to force GPs to extend their opening hours and feel this is seen as a potential vote-winning issue by Gordon Brown in this current climate of falling Labour popularity.

Our Prime Minister is thus bullishly pursuing voters' crosses with blatant disregard for evidence-based care.

I was shocked by Lord Darzi's interim report, coming out as it did during Mr Brown's bottled pre-election campaign. He trumpeted the fact he had consulted more than 1,000 NHS employees to produce his document. This amounts to barely 0.1% of the NHS workforce.

At best, it is a woefully unrepresentative sample - and at worst a collection of party activists diligently toeing the line.

From Dr Steven Chavasse, Bideford, Devon

So, the Government is going to unilaterally change the GP contract for reasons that are transparently political and in a way that might damage care.

My first thought is that any contract that can be changed by one party only, without the agreement of the other, is not worth the paper it is written on.

My second thought is that if this Government wants war with the profession, it might at last have achieved its aim.

My only hope is that this will finally unite GPs and make the Government regret these actions at its leisure. We need to demonstrate to the Department of Health that it needs to engage with GPs rather than attack us.

For example, from where I am standing, the NHS spine looks very vulnerable. The recent debacles over the loss of confidential information by Government departments have shaken public confidence, and I for one will only download patients' data on to the spine with their written and informed consent.

This simple action is likely to cripple the project if all of us do the same.

I am sure there are many other areas, such as Choose and Book, where we can make life very difficult for the Government without damaging patient care.

I hope this time the GPC will not back down.

From Dr Malcolm Golin, Rickmansworth, Hertfordshire

I am disgusted by this Government's pathetic bullying tactics.

It is time for GPs to make a stand - we should, all of us, completely refuse to take on any extended hours DES.

From Dr Andrew Senior, Kingstanding, Birmingham

I read with dismay Dr Susan Bowie's comments justifying extended opening hours with an example of being available for a medical emergency.

If GPs themselves are incapable of distinguishing between the issue of extended hours for routine consultations and the provision of out-of-hours emergency cover, then God help us all.

From Dr Tim Atkinson, Littlehampton, West Sussex

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