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Reality is 'no pay, no work'

As another financial year draws to a close, GPs will be able to look back with pride on what they've done.

QOF achievement in the second year of the new contract will outstrip even the sky-high levels of the first year. That means quality of care for patients is better and GPs will justly reap the rewards of this in their take-home pay.

Access has also improved immeasurably, as our page 3 story on the Picker Institute's million patients survey shows.

Yet despite these successes, GPs will look ahead to 2006/7 with trepidation and a degree of gloom. Income is frozen. New money in the form of the directed enhanced services looks of dubious value. And practice-based commissioning appears fraught with risk.

Weigh up value of every job

These conditions will test GPs' business skills to the limit. As Dr Andrew Dearden states this week (front page), GPs now truly have to act like plumbers, dentists and other small businesses and weigh up the value of every job they do.

While income grew over the past two years, GPs could afford to continue doing some unpaid work. That time is now at an end.

A heating engineer would not go on an emergency call out without a guarantee of being paid by the gas supplier. Yes it's immediate and necessary work. Yes the customer could be inconvenienced if they don't attend. But the commercial reality is 'no pay, no job'.

That's the reality for GPs this year. And they must make PCTs, the NHS and the Government face up to it.

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