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CAMHS won't see you now

New contract has to be better than current one

Why are so many of my colleagues so gloomy about the new contract?

Your latest issue had, at a rough count, 14 articles or letters against the contract, four neutral and only four in favour. Your editorial was critical of the GPC for having 'wasted many GPs' time', and the roadshow I attended in Taunton had some of the hostility you reported at the Manchester roadshow.

This scepticism is understandable. Change is always anxiety-provoking, and we would be stepping into very new territory ­ but I am much more anxious about staying as we are.

We should remind ourselves that the members of the GPC negotiating team are our colleagues. They are conscientious GPs (a number of them in small rural practices which some suggest will suffer most) who, on our behalf, have put an enormous amount of hard work into persuading the Government to agree a contract which, even without the final figures, offers far more to our advantage than against.

Even in areas where the GPC openly admits only limited success ­ such as pensions, allocations and computerisation ­ we will still be in a better position than under the current arrangements. Let us not forget that the current contract, with its lack of evidence base and its anti-GP slant, was forced on us because we didn't agree an alternative, and it has led to our present state of overwork, pessimism, demoralisation and lack of job satisfaction.

We now have a real chance to turn things around for ourselves if we are prepared to make a bit of effort. It might be true those practices that have not kept up with the modernisation of primary care could get left behind, but the preliminary figures suggest they are unlikely to be worse off than now: like all of us, they will be protected by the transitional payments, and they will get more help towards helping themselves.

We have the opportunity to organise ourselves in a more sensible and favourable way, and the point system is evidence-based, so by doing for our patients what we should be doing anyway we can earn a lot more than we do now. Ticking a box on the computer seems a small price to pay.

The new contract is not that complicated. Even I can understand most of it, which is more than I could say of the Red Book ­ and I believe we can trust the GPC to have carefully examined the tricky bits such as the Carr-Hill formula. The contract is more GP-oriented and much of the arbitrary power of the PCOs will be removed.

They will also take a good deal of the bureaucratic load from us. The most heavenly thought of all is that we can rid ourselves of our out-of-hours burden at a relatively small price ­ but you don't have to if you really believe it's important.

The PCOs have all sorts of ways in which to provide appropriate out-of-hours care while we can put our energy into quality time with our patients at more agreeable hours.

I have no particular axe to grind ­ my best mate isn't on the GPC negotiating team ­ but, thanks to their efforts, I now feel optimistic about the future of primary care.

So cheer up and vote Yes. Or think of the alternative and stay gloomy because, just like last time, nobody is going to come up with a better deal.

Dr Richard O'Brien

Bridgwater, Somerset

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