It seems to me that there are strong threads of disillusionment from most of the bloggers here and also it seems the younger cohort of GP's feel understandably aggrieved that, not only will they have to put up with the new contract arrangements for more of their career but to add to the injustice they know that older GPs will have a better pension, more so now that younger GP's will not receive seniority pay themselves in due course -- does this mean the older GPs have profited at their expense as some have suggested?
I think this view of pensions is an oversimplification because what has really happened is that, broadly speaking, GPs will have their existing pension contributions honoured, but younger GPs unfortunately have been forced to switch future contributions to a less favorable scheme -- for that we should blame the government/Department of Health and not the older GPs, although older GPs have a lot to be thankful for I agree as they have already completed most of their career in the better scheme.
It is very important however that we do not do what the government wants us to do and start bickering amongst ourselves.
Let's come back to the 2014 contract settlement.
Majority opinion here anyway, I presume both young and older GP's, is inclining towards the view that the GPC now seem to approach all annual contract negotiations hoping for the ' least worst' outcome - so that we should be grateful for anything that is granted to us, in this case less box ticking, howver no new money or resources. I may be cynical, but if you were a cunning negotiator in the Department of Health/government, perhaps you would put some highly unreasonable boxes in the 2013 contract so that hey presto, these can be removed in the 2014 contract thus convincing the GPC negotiators they have got a brilliant deal -after all they have only agreed to scrapping of practice boundaries, named GPs for over 75's and publishing of GP incomes, all for the same resources.
Most grassroot GPs have a very clear concern that this contract will not lead to a 'named clinician', but a 'blamed clinician' when anything goes wrong with the care of patients over 75 years of age -- notwithstanding the many other variables required for vulnerable elderly patients to flourish in the community such as good family backup, community and social care and support, including mental health and other support services and in appropriate cases prompt access to the emergency services and good secondary care.
By the way I seem to remember that it was going to be the 'appropriate clinician' who would be the namd doctor -- not the GP in every case, why and when did that change?
Is this another example of GP's being singled out for special treatment?
If you doubt that GPs are being singled out may I ask why has the primary care share of the NHS budget shrunk from 10% down to 7%,whilst GP FTE numbers remained static whereas consultant numbers increased by 40%, whilst concurrently much of the workload has been shifted from secondary to primary care over the past decade?
What were and are our leaders thinking of?
Regarding the disillusionment which is clearly widespread amongst grassroot GP's, and expressed on the blogs on pulse particularly, I disagree that the options are either agree, strike or exit stage.
I would suggest that a strike has little chance of success which has already been demonstrated by the previous GPC led strike when only it seems at the last minute was the legality of the issue even considered and threats were made that doctors would face legal action if they were on strike.
May I propose that if GP's genuinely wish to consider a viable alternative option, a like-minded body should convene to explore the option of supporting and furthering the aims of those GP's who are interested in becoming truly independent contractors, rather than GMS/PMS. In many cases one would presume resignation from partnership would be the first step.
Some of our locum colleagues, many of whom have decided they do not wish to become partners, have already gone down this route with the formation of a cooperative model, similar to the concept of legal chambers -- perhaps that could be adopted on a larger scale, if enough GP's were interested?