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GP leaders to vote on whether to support patient charges for appointments


Despite the attempt that the GPC made, it seemed with initial success, with the 2004 contract to change the method of funding of primary care and deliver increasing resources for increasing work, the politicians have deviously undermined that agreement by portraying us as greedy, overpaid and incompetent ever since. The 'John Wayne' contract lives and breathes, despite rumours of its demise in 2004. As a result of political bullying, with the full cooperation of the media, our leaders have been cowed into accepting worsening contractual obligations for GPs every year since 2004. The main problem being ever increasing workload, fuelled by the fantasy propagated by politicians that unlike any other field of human endeavour, an ever increasing, supposedly unlimited in fact, supply of high-quality produce is available within a strictly constrained budget. It seems to me that the strategy of shifting the public debate as to how a realistic and sustainable method of funding for primary care can be delivered is now entirely correct. On the contrary, the existing strategy of fighting for a reasonable contract without questioning the basic system within which that is delivered (the NHS free at point of delivery etc) has proven disastrous. Unfortunately we have played into the hands of politicians by letting them choose their battleground -- the danger being that GPs will now be portrayed as even more greedy because they are asking for payment for item of work done (or at least top up funding per consultation) and thereby undermining the principles of the NHS. The 2012 BMA strike to protest against changes to the NHS pension was not just ineffectual and misconceived (it seems that even the legal position had not been clarified in advance) but further undermined our standing in the eyes of the public, rather than engendering their sympathy -- because of what we chose to protest against. It must be clear to the public that, if we choose to protest in future, we are not campaigning simply for more money, rather we are campaigning for terms and conditions which permit us to deliver the service to the required standards in a sustainable way. Ultimately, the public have to realise that they cannot receive high-quality readily accessible care without the system being adequately funded. The question as to how that system is designed and funded should be opened to democratic debate. It seems to me at the moment we have politicians acting like an elected autocracy, certainly with regard to the design of the NHS -- remember the election pledge 'no top down changes' anyone? Maybe the politicians wish to stifle debate, whilst they implement a policy of privatisation by stealth? In conclusion, the political leaders of the medical profession in my opinion should advance the argument that the interests of the public and GP's, in securing a system adequately funded to deliver ready accessible and high-quality care, are aligned -- and not necessarily identical to the interests of their political lords and masters, who aspire mainly for their own reelection and quite possibly the piecemeal privatisation of the NHS. Privatisation may be inevitable but it should be subjected to public scrutiny and debate before it becomes irreversible.

Posted date

07 May 2014

Posted time