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At the heart of general practice since 1960

The road to a new GP contract

Looking back over the past

18 months to pick out the key dates in the new GP contract negotiations, one thing is clear: Friday June 1, 2001 was a watershed (although the rumblings of discontent had started sounding a long time before). On that day, less than a week before the general election, the BMA published ballot results which clearly demonstrated just how unhappy GPs were.

In April last year, the GPC negotiators spelt out to the committee the areas in which talks with the Department of Health had stalled. The profession was balloted, asking if doctors would be prepared to consider submitting undated resignations from their current NHS contract in a year's time if a new GP contract and GPC negotiating rights for all family doctors could not be agreed with the Government within the next 12 months.

An absolute majority of all 37,000 GPs in the UK said they would consider resigning. The overall UK-wide response rate to the ballot was 66 per cent. Of these, more than eight out of every 10 GPs (86 per cent) voted Yes. Similar high response rates and overwhelming Yes votes were returned in all four countries of the UK.

This ballot gave the GPC a mandate to seek negotiations on a new GP contract ­ a policy which was endorsed at the Local Medical Conference in June 2001 with a brief to be radical.

On July 6 last year the Government said it had asked the NHS Confederation to act as its agents and negotiate with the BMA on a new GMS contract.

Talks began in earnest in the autumn. Alongside the negotiating activities we held a massive consultation exercise. All UK GPs were asked to complete a detailed questionnaire with more than 50 questions about morale, job satisfaction, how they rated the NHS, the range of services offered in their own practice and their personal aspirations for improving their working life.

The results of the National Survey of GP Opinion were published on October 17, 2001 and have helped the contract talks. The survey revealed that doctors wanted a radically different contract that gave them more time with individual patients, controlled their workload and substantially improved their pension rights.

A quarter of all GPs said they were seriously considering leaving general practice in the next five years and almost half of them (48 per cent) now planned to retire before the age of 60.

Intensive negotiations with the NHS Confederation led to the publication on

April 19, 2002 of Your Contract Your Future, the document setting out the proposed framework of the new contract with explanatory notes. More than 50 roadshows throughout the UK followed at which GPC negotiators met about 15,000 GPs and answered their contract questions.

In the week of June 10, 2002 ballot papers went out to GPs and GP registrars asking if the new contract framework was an acceptable basis on which to proceed to the next stage of detailed negotiations and the preparation of a priced contract on which they would be balloted. The closing date for return of ballot papers was July 8.

Ballot results announced on July 16, 2002 showed that, in a turnout of 65.2 per cent, 75.8 per cent of voting GPs wished to proceed with final negotiations and 24.2 per cent voted No.

Armed with this decisive mandate, the GPC entered into the second stage of negotiations. The negotiations are on course for the final detailed contract to be sent to the profession early in the new year, with a ballot on its acceptability in February 2003. Roadshows to answer questions on the priced contract will take place throughout the UK in January. If GPs accept the final priced package, there will be substantial implementation of the new contract from April 2003. Only those parts requiring primary legislation are likely to wait until 2004.

April 2001

 · Talks between GPC and Department of Health about future of general practice stall

June 2001

 · BMA ballot reveals extent of GPs' disillusionment with conditions within general practice.

 · Ballot gives the GPC a mandate to seek negotiations on a new GP contract

 · Local Medical Conference endorses this mandate

July 2001

 · NHS Confederation asked by Government to act as its agents and negotiate with BMA on a new GMS contract

Autumn 2001

 · Talks begin between GPC and NHS Confederation

 · GPs asked to complete questionnaire about aspects of their working life

October 2001

 · Questionnaire published as the National Survey of GP Opinion

Autumn 2001 - spring 2002

 · Negotiations between GPC and NHS Confederation continue

April 2002

 · Publication of Your Contract Your Future - the document setting out the proposed framework of the new contract

Summer 2002

 · Roadshows, in which GPC negotiators answer GPs' questions about the contract framework

June 2002

 · Ballot papers sent to GPs asking if they felt the framework was an acceptable basis on which to proceed to the preparation of a priced contract

July 2002

 · Ballot results announced. Turnout of 65.2 per cent of GPs. 75.8 per cent of voting GPs vote to proceed

Autumn 2002

 · GPC and NHS Confederation enter second round of negotiations

Proposals for 2003

January 2003

 · Contract to be priced

 · Further roadshows

February 2003

 · Priced contract to be voted on

April 2003

 · Substantial implementation of the new contract if it is voted in by GPs

As the pricing of the new contract approaches and GPs prepare to vote, Dr John Chisholm, chair of the General Practitioners Committee, reminds readers of key events as they have unfolded

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