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CAMHS won't see you now

Pensions

Dr Baljit Bhullar singlehanded GP working to GMS rules

on PMS pay in Feltham, Middlesex

The contract's impact has definitely been negative. We cannot now say our lists are

closed. If we do, we are ineligible for enhanced services. We're in a catch-22 situation.

I know there are patients with problems, and we take our fair share whether we like it or not. But the contract has certainly had a financial impact, and though I can't measure it yet, it's definitely been negative.

Allocations cause particular problems if the patient is housebound. Home visits for housebound patients are no good because you can't do the things you would in the surgery and you can't carry all the equipment you need.

It affects me personally quite a lot and the prospect of my retiring has become much more likely now.

In the back of my mind I feel these patients are disadvantaged because they've been moved from A to B to C to find a doctor. But we accept them.

The allocations issue has weaselled its way into the contract. I think we must invest in doctors. Allow us the liberty and financial ability to recruit and to mobilise doctors to do these home visits and so on.

Dr Steven Nimmo GMS GP at a three-partner

practice in Plymstock, Plymouth

The contract has failed to deliver on the issue of allocations and the

practice faces a potential nightmare in the future because of a possible new housing development in the area.

There are three practices in this area and at any one time at least one of them has its list closed. I would like to see allocations stopped completely. We only turn people away if we think our list is full. We don't really appreciate having people foisted on us if our list is full. It degrades the service we are able to offer patients.

All of us consider that we have as many patients as we can handle. We have been told there is this new development planned in the area, with a possible 4,000 to 5,000 patients. It hasn't yet had planning permission but if it goes ahead, I can't see any earthly way that we can take those patients on. The PCT will have to find some way of dealing with it. Overall the contract has failed on allocations.

I think our hope was that allocations would stop. From the hype, we thought we would see an end to them, but perhaps my expectations were unrealistic. It was one thing that the negotiators were trying to sort out.

Dr Ali Prust GP in a three-partner GMS practice in

Exmouth, Devon

It's hard to tell whether the contract had delivered on allocations. There are five

practices in Exmouth so we get the occasional one, but generally we are not that bothered by them.

The contract has helped because violent patients can be referred on to other services. But there is no easy answer to the allocations problem because everyone is entitled to have a GP. In a small town you can be allocated patients who you have a history with, and then it becomes very difficult to establish any sort of useful relationship with them.

Dr Stephen Lawrence singlehanded GMS GP in Chatham, Kent

It is not an issue that is affecting me directly at the moment. I haven't had any patients allocated in the past six months so that area of the new contract hasn't

affected me. I do have an issue with patients who leave my area and wish to remain on my list. The PCT tells them it is up to me, which sometimes puts me under pressure.

We used to have three months in which to remove patients and now it is far more difficult to do that. It should be easier to remove patients who are problematic.

Interviews by Rob Finch, Nerys Hairon and Cato Pedder

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