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GPs go forth

Backlash from grassroots GPs as survey highlights fears over contract compromise

Exclusive: Almost two thirds of GPs believe this year’s contract agreement represents a ‘poor’ or ‘very poor’ deal for the profession, with plans to publish GPs’ earnings, scrap practice boundaries and phase out seniority pay causing most concern, a Pulse survey reveals.

The 2014 contract deal, which was announced on Friday, has been welcomed by many GP leaders, with the GPC declaring the compromise ‘acceptable’ and the RCGP and Family Doctor Association also broadly supporting the outcome.

But a Pulse snapshot poll of some 360 GPs over the weekend suggests many grassroots GPs have misgivings about the deal.

Some 73% of respondents backed the reduction in the QOF and 78% welcomed the reinvestment of some QOF funding in the global sum, while moves to improve online appointment booking, give all patients access to Summary Care Records and offer repeat prescription requests online were also welcomed.

But 78% were opposed to plans to publish GPs’ earnings, 76% did not agree with the phasing out of seniority pay and 73% were unhappy with the removal of practice boundaries.

Around half of GPs were also opposed to some of the more high profile changes, including the introduction of ‘named GP’ responsibility, a requirement that practices monitor the quality of out of hours care and the creation of a new unplanned admissions DES.

Asked how they would describe the deal as a whole, 3% said it was ‘very good’ and 33% ‘good’, while 43% said it was ‘poor’ and 21% ‘very poor’.

GPs commenting on the deal on Pulse’s website were divided over its implications.

Dr Shaba Nabi, a GP in Bristol, said: ‘I get the feeling that if the GPC was punched in the face, they would be grateful for not getting a broken nose. Where is their backbone?

‘The loss of seniority has got to be one of the most sinister and stupid ideas yet. If we have thousands of GPs over 55 waiting to retire…this has got to be a massive reason to do so. So what exactly is that going to do for recruitment and retention?’

Dr Fadi Khalil, GP in Sunderland, said: ‘The named clinician part is still very vague. Are we talking information sharing or actual involvement in every decision no matter when why or how?

‘Obviously there is no extra funding and I suppose within this reshuffling of contracts, money will be siphoned out as always. I expect a reduction in total income again for GPs. At a time where we haven’t had a paylift for 10 years and we have had had real-term painful pay cuts as well as a rise in expenses and salaries, I think this contract does nothing but politicise the contract. It makes it beneficial for the Government to brag about meaningless objectives while we are doing the hard work and getting nothing back.’

Dr Coral Jones, a GP in Hackney, east London, expressed concern over the removal of practice boundaries.

‘This will be the end of general practice which is able to provide comprehensive care for every person registered in the UK for about £140 per year. This is incredibly good value. Abolishing practice boundaries is just a gift to the private sector to sweep away more of the NHS.’

But Dr Janette Lockhart, a retired GP from Ashton-under-Lyne, Greater Manchester, said: ‘The new contract sounds good in part, especially the reduction in the QOF. I hope that eventually disappears completely as, for me, that was the thing which had the most detrimental effect on enjoyment of the job.’

Responding to Pulse’s survey findings, GPC negotiator Dr Peter Holden pointed out there was a small sample size but defended the deal, insisting it was ‘the best we could do’.

‘You have to remember the environment - there is no new money and the Treasury wanted to impose something far, far worse,’ he said.

‘People need to wake up and smell the coffee. This was the best we could do, we were offered far worse and we were against a timetable.

‘I actually think when people really see the detail and analyse it, the devil is absolutely in the detail this time.’

Readers' comments (34)

  • Thank you for what will be no change to my workload and a significant pay cut over my working life. Which undergraduate in their right mind will choose GP as a career path.

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  • Hazel Drury

    Pulse, once again your survey ignores single handed GPs. I ticked "GP other" (as opposed to GP Partner as I am not in partnership with anyone) so the survey ended. Doh!

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  • I think the contract changes are fine. Most of the things in the contract I already do, like taking phone calls from hospitals and ambulances about patients. I think the named clinician makes sense and most people over 75 already see one favorite GP. This just formalizes that.

    The contract gets rid of the pointless QUIPP meetings, which take up a fair bit of time and scraps some of the terrible DESs (remote care) etc.

    The red line for me would have been if I had to be awake/ sober/ around between 6.30pm and 8am. That has not changed.

    The real test will be if seniority does in fact get rolled into the global sum (and not sold as a pay increase). At the early stage of my career - that will work out about neutral for me. It penalizes those towards the end of their career as they have not benefited from the increased global sum in the early part of their career.

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  • I think that there is some progress with this contract, particularly the recognition that QOF has gone tto far down the boxticking route. My major concern (given the governments track record) is how we ensure that these monies (QOF, seniority, MPIG etc) genuinely get recycled into the global sum. I can't help thinking that the global sum will not increase as much as a mathemetician would calculate it should. Let's face it, the government does not have transparency as it's watchword.

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  • 24 hour responsibility for single handed practitioner is extremely unfair. some area may only have one or two practices in village . if gp's don't get on well with each other then where are they suppose to go?. working with other practices !! patients who change doctors do not want to see previous gp's. would it not reduce patients choice to change gp's.
    qof bureaucracy is is reducing, is good news but actual money saved should be added to correction factor for those who have small global sum.

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  • Publishing pay is a good thing. Corrected for expenses and employers superann as then people will see we don't earn 100 or 200k but more like 80k. And I think most people would think that reasonable.

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  • if anyone is naive enough to think there will be genuine recycling of QOF, seniority monies, they need their heads examined. Equally I don't think published pay will be post superannuation, it too will be published in an unfavorable way.

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  • The contract is one of the worst negiotiations in medical politics

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  • "publishing gp's income " is there so it can be removed. they will say we compromised on this and seniority allowance and in return gps will support changes.
    is is no big deal to publish gp's earning. let them know doctors earn decent wages from their independent business.

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