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A faulty production line

Mass screening for diabetes cuts deaths by a fifth

Negotiations over local enhanced services are now being described by some GPs as a lost battle. The new contract, with its categorisation of services, was supposed to have brought with it the ability of GPs to say No to services they do not want to provide, or are not funded. Fine in theory, but it was never going to be quite so simple for altruistic GPs faced with patients in need of treatment.

And with more and more calls on primary care trusts' money, the hope that there would be enough resources to develop new services has got correspondingly smaller and smaller, increasingly prompting trusts to look elsewhere for cheaper alternatives to GPs.

While the battle may be lost, GPs do have an opportunity to win the war. Getting involved in practice-based commissioning and seizing control from PCTs could provide an alternative path to victory.

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