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The twisted logic of the ‘New Contract’

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Another day, another promise/threat of a new contract. This time, it was announced by David Cameron during Andrew Marr’s news-driven chat show – appropriate because it was news to the GPC, and they’d probably like to have a chat about it.

It’s interesting to scrutinise the exact wording of DC’s announcement. In case you missed it, he said: ‘I don’t think anyone is happy with the GP contract, so this new contract will focus on making sure that people in our country can get access to a GP on seven day a week basis, 8am to 8pm, that’s what we want to see.’

The Government has a vision. They know what they want to see. And one way or another, they’ll see it.

As an exercise in knight’s move thinking, it’s quite breathtaking. Consider its three parts:

a) ‘I don’t think anyone is happy with the GP contract’. Clever, a classic Cameron ‘We’re all in this together’ opener, seducing us into thinking that everyone’s on board from the outset.

b) ‘So this new contract will focus on making sure that people in our country can get access to a GP on seven day a week basis, 8am to 8pm’. How can a) get to b) via ‘so’? It can’t, because it’s a complete non sequitur, yet it appears it has. In other words, he’s saying that no one’s happy with the contract, so he’ll sort out a new one that no-one other than the Government needs, wants or will be happy with. And he’s saying it as though it makes some kind of sense.

c) ‘That’s what we want to see’. Though we’ve inexplicably jumped from the inclusivity of ‘everyone’ in the opener to the more exclusive ‘we-as-in-Government’ in the sign-off, there is at least a sense of twisted logic here: the PM is acknowledging that, while what he’s saying might be drivel, it’s exactly the type of drivel they’re after.

Don’t fret if you find all that rather confusing. Because the words with real clarity and import came, at a Tory Party Conference session, from the Health Secretary rather than the PM. According to Jeremy Hunt, ‘Labour signed a disastrous contract in 2003 and since then, in penance really, the NHS has not really wanted to put extra money into general practice’. So there you have it, as if you didn’t know already. Twelve years ago, we negotiated in good faith a deal which, at the time, saved many in the profession from burnout, improved quality of care beyond any politician’s wildest predictions and helped boost flagging recruitment. And we’ve been persecuted for it ever since.

Whether Dave’s new ‘New Contract’ will be further punishment along similar lines, or a tempting juicy carrot, time will tell. But one thing’s clear. The Government has a vision. They know what they want to see. And one way or another, they’ll see it.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield

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Readers' comments (7)

  • Vinci Ho

    Reading through what Darth Vader said in his speech in the party conference yesterday , he was trying very hard to convince people that(1) Conservative party is the only party in the middle ground of politics(he spit out a lot of politically correct socialist rhetorics ignoring classical old school conservative ones ) (2) nobody is better than him as the PM.(3) the labour leader was 'evil' spirit.

    So the leader in the front stage is 'kind' no matter how nasty his subordinates are from behind the curtain. That's why the part about anybody was happy about the GP contract , was so equivocal. So was the part about getting access to 'a' GP on seven day basis.
    The interesting question is does he believe his cabinet(not necessarily his whole party)has enough 'political capital' to gamble for 5 years?
    Our revolution has only just started and history will judge.....

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  • I think this is going to be as damp a squib as the promised £75,000 cap on care costs.

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  • Work to rule people and be strict about it. Only then will they realise how much GPs take on ; for peanuts.

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  • Russell Thorpe

    Im not unhappy with the present contract. My main issue with it, which I raised with LB at one of the road shows, is the fact that it can be altered unilaterally.

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  • Simples - Quit or vote your CCG board out in protest. Seems we don't have many other options left.

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  • The junior doctors have more gall than our GPC. What about a ballot re resignation.?

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  • Anonymous | Practice Manager09 Oct 2015 3:24pm

    Simples - Quit or vote your CCG board out in protest. Seems we don't have many other options left.

    What have CCG boards go to do with this? This is worrying that a PM doesn't understand that ultimately general practice is contracted to the NHS and that the GMS contract is a national contract and hence nothing to do with CCGs. And yes I am on a board and us as well as plenty of other CCGs are committed to investing in Primary Care and reversing the trend of investment pouring into secondary care. But CCGs can't just give money to GPs for nothing - they have a responsibility for commissioning safe and quality services for their population, whilst ensuring that, and being accountable for, public money is spent wisely to achieve this. At least there are some people who are willing to put their heads above the parapets and take responsibility for doing things differently. If seven day working is funded adequately it can massively increase capacity in primary care and relieve some of the day to day workload during the week. It may be the only way to get investment into primary care but I do remain sceptical whether it will receive adequate funding to do this. Our local experience has demonstrated what the real costs of an extended access service are.

    Lets stop this 'them and us' mentality that seems to exist between some members and CCGs. Yes if the board are underperforming or out of touch with members then vote them out but not as a protest against central government

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder