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At the heart of general practice since 1960

Let’s think the unthinkable and resign from the NHS

The Government tactic of offering a change of contract, which if not accepted would be replaced by the imposition of a more punitive one, is the beginning of a campaign to remove GPs from their present role within the NHS and replace them with privately run polyclinics.

The only reason the Government has not been tougher is that polyclinics and the EU staff to run them are not quite ready. But they soon will be.

In accepting the imposition of a punitive contract change, we will be signalling to the Government that it can run roughshod over us any time.

Next will be a significant change to the MPIG. Then it will be too late for us. We will be bankrupt if we stay, and we will have nowhere to go because polyclinics will already be up and running.

To resign now is our only option. Then we have time to make the best of our most important asset – continuity of care.

No matter how good polyclinics are, they will quickly resemble what is most disliked about the out-of-hours service. In order to keep costs down, polyclinics will inevitably be run with the minimum number of doctors possible and probably with a high turnover of staff.

We are told we are now some of the best-paid GPs in Europe, so it is obvious private enterprise would look outside the UK to recruit doctors.

Be afraid. Be very afraid.

Name and address supplied

I fail to see what we have to lose in resigning now. I agree it would be damaging to our relationship with patients, but this is going to happen anyway. The Government has failed to deliver on health, having wasted vast sums on pointless projects and reorganisations.

By resigning we risk financial loss, but this would be short term. For many GPs, pay is about to fall to pre-contract levels, despite the additional work from the QOF, Choose and Book and practice-based commissioning.

Next will be the abolition of the MPIG and later the resumption of 24-hour responsibility for between £0 and £6,000 each.

Although I have a family to consider, the risk of quitting now is justified as I want to be able to support them in future years and to spend time with them, rather than working 8am-9pm six days a week for a population who assume we are being paid far too well anyway.

If we were to fail then we could be re-employed on potentially unfavourable contracts. But we all must now know that our contracts are worthless and our terms of service will become ever more unfavourable.

So resign now. Prevent the Government continuing to adopt the strategic supremacy which will destroy traditional general practice.

Dr John Evans, High Wycombe, Buckinghamshire

The BMA's suggestion that GPs resign from the NHS in response to Government plans to enforce extended hours seems a good plan, but will not materialise.

Ministers are well aware that many GPs would be too scared to leave the NHS, as it provides them with the security of a job and pension.

From the inception of the NHS, every government has in one way or another imposed a punitive and restrictive contract on GPs. All these have offered is bondage and slavery. The profession as a whole has always been disunited.

How can GPs call themselves independent contractors when the contract is always imposed and one-sided?

But GPs should realise that resigning from the NHS may be good for them and

the nation as a whole. It would stop the Government from imposing ridiculous targets and bureaucracy. The only loser would be the Government, in terms of votes.

Most other professions – such as dentists, vets, solicitors and accountants – manage very well in the free market. In most parts of the world doctors' services are charged for, and most have far better health services then we do.

So if the Government does decide to impose a contract on GPs, we should think the unthinkable and consider the option of resigning.

From Dr Fatehali Hirji, Hemel Hempstead, Hertfordshire

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