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'Unwinnable' battle on opening hours behind GPC contract climbdown

By Steve Nowottny

GP leaders are backing the Government's contract offer because they fear extended hours has become an ‘unwinnable' issue that could destroy relations with ministers and patients for good, Pulse can reveal.

The GPC's hugely controversial vote concluding that the deal on the table is ‘less damaging for general practice' than the alternative of an imposed contract came in spite of overwhelming demands for a No vote by many LMCs.

The climbdown sparked a massive GP backlash ahead of a national poll later this month.

GP negotiators' initial claims that the decision had been prompted by ‘sufficient movement' from ministers to make the deal more palatable quickly began to unravel. Pulse understands the only concession secured is that the number of extended opening appointments per hour will be set locally – and that GPC members were not even aware of this when they voted overwhelmingly to favour the Government offer.

GPC members told Pulse the real reason negotiators backed down was the fear that months of anti-GP spin had done its job. GP negotiator Dr Peter Holden admitted: ‘It doesn't matter if no concessions have been won. The bottom line is there's no point being offensive to those people and making them take their bat home. It would have meant closing the door to negotiation. The Government has shown it will use the full power of the law to get its way.'

Under the Government offer, the average 6,000-patient practice will have to offer three extended hours a week or face losing £18,000. But several LMCs have already written to GPs warning them if they opt into the extended access DES, staff, heating and expenses costs will outweigh income. The LMC letter stresses the DES is voluntary.

One GPC member highlighted how the dispute has divided the profession after he revealed that the GPC's own figures showed a 50:50 split on whether to vote Yes or No among about 2,000 GPs attending LMC meetings over the past few weeks.

GPC chair Dr Laurence Buckman wrote an emotional letter to GPs, pleading with them to understand the GPC's stance. ‘You cannot imagine how hard it is to do my job when I am reading this level of venom directed at us,' he said. ‘In my view the extended hours stuff is a smokescreen for a much larger battle. Standing up to the Government is about knowing when you can win.'

But some GPs accused him of a humiliating U-turn. Dr David Stokoe, a GP in Liverpool, fumed: ‘Your call to arms has been the most laughably inappropriate since David Steel's "prepare for Government" speech. As a latter day Grand Old Duke of York, you marched us up to the top of the hill then ran away.'

Concession - what concession?

GP negotiators claimed they had secured significant movement from the Government – so what was this apparent concession?

Alastair Henderson, deputy director of NHS Employers, said: ‘The changes were designed to make clear that routine booked appointments should be given in accordance with normal working practice, rather than specify any particular required number.

‘This sensible change allows additional access to be shaped in line with local requirements.'

Dr Laurence Buckman, GPC chair Dr Laurence Buckman, GPC chair Dr Laurence Buckman on what prompted the change of heart Dr Laurence Buckman on what prompted the change of heart

They have softened the wording and made certain things that that were very prescriptive less prescriptive. GPs will still have to make up their own minds and we are not going to tell people how to vote

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