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Revolution: April 1

A new era for GPs begins this week ­ Pulse marks the biggest change for 40 years

Better infrastructure

'It will require new electronic health records and IT systems, new incentives, but above all greater recognition of the role that GPs, nurses and other members of the primary care team can each play ­ when properly resourced and supported.'

Tony Blair, Prime Minister

Better pay, better quality

'GPs have always wanted to give patients the highest quality of care and the new contract gives them the opportunity to be rewarded for doing that.'

Professor Martin Roland, an architect of the quality framework

Good news for PMS

'It's a good opportunity on the PMS side. The biggest danger is PCTs don't look at the broader strategic picture. We must start to plan today if we are going to develop care for tomorrow.'

Dr Mo Dewji, national PMS lead, Department of Health

Added stress

'We all know the good ship NHS is sinking slowly. We apologise for its failings every day. Wouldn't you be stressed if you worked in the engine room? Doctors are jumping ship every day, or wanting to. The new contract is just rearranging the furniture on deck. We are still in the same boat. Trying to persuade the angry passengers all is well. Is that an iceberg ahead? Where are the lifeboats?'

Dr Tony MacDonnell, GP, Kent

Reduced workload

'I always hear the phrase "It's the end of the NHS as we know it". Well it is. That's what GPs asked for ­ not just something new but something that would at last recognise workload. It's going to be an enormous change.'

Dr Laurence Buckman, GPC negotiator

More choice

'The new GP contract frees doctors up a lot more to develop their own services in an entrepreneurial way. As a result lots of services previously only available at secondary and acute level will become available in general practice.'

John Reid, Health Secretary

Biggest change

'This week sees the biggest change in general practice through the mechanism of contract since the NHS began.'

Dr John Chisholm, GPC chair

Insidious consequence

'This is the boldest attempt to improve the quality of primary care ever attempted anywhere in the world ­ with one mighty leap the NHS vaults over anything in the US. But one insidious consequence is the potential for change in the relationship between doctor and patient. Will patients no longer be persons to the GP but a series of performance targets to be met?'

Paul Shekelle, professor of medicine, UCLA

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