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CAMHS won't see you now

1% is peanuts, but it is all part of Hunt's grand plan

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The rumours were true. The new contract brings little to make a big difference to the hole general practice has fallen into.

There are some welcome developments – binning the controversial dementia DES and no changes to the QOF – and an actual inflation-busting 1% pay uplift is welcome. 

For the first time in many years we also see a real effort to address rising practice expenses, with an additional 2.2% to cover recent hikes in indemnity costs and employers’ national insurance and pension contributions. After nearly a decade of pay cuts, I guess GPs have paid their 'penance'.

But this is all pretty small-scale stuff when you consider the massive problems with recruitment, the rising numbers of patients displaced by practice closures and the devastating impact of cuts in MPIG and PMS funding.

Jeremy Hunt is playing the long-game 

And there are some potentially significant pieces of additional work that are buried in the small print. Practices 'will aim for’ at least 10% of registered patients to be using online services and will have to record data on evening and weekend opening hours and 'the number of instances where a practice pays a locum doctor more than an indicative maximum rate as set out by NHS England’. Sounds ominous.

All the rhetoric about putting the ‘inspiration and magic back’ into GPs’ working life looks a little bit hollow.

But I get the sense that the health secretary wants it this way. He wants to engender a sense of dissolutionment before he comes in, superman cape fluttering with a lovely pert 'package‘ of measures that will 'save’ general practice.

He wants to make the national contract look like a bag of the proverbial as it suits his longer-term aim to undermine it and introduce his own sparkly seven-day ‘voluntary’ GP contract to push forward his manifesto agenda.

Watch as GPs are promised extra funding in return for a whole list of new responsibilities that will make Mr Hunt’s boss in Number 10 very happy and will suit perfectly the aims of the Five-Year Forward View.

I may be wrong, but I sense Jeremy Hunt is playing the long-game here, and the forces are being gradually lined up to divide the profession and side-line the BMA and Labour's maligned 2004 contract.

For some GPs this will be a welcome release from the constraints of the current system, and in the short-term it could prove lucrative for practices to make the leap and start to form a truely primary care-led NHS, but there will be no going back once the genie is out of the bottle.

A similar game was played with the juniors, now it is GP’s turn.

Nigel Praities is editor of Pulse

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Readers' comments (16)

  • Quite well put in the article I think. Essentially J #unt wants the doctors to pack up and leave, preferably to co-pay or private healthcare. That opens the door to bring in his buddies Netcare and the US companies, whilst blaming GPs. The problem is that neither NHS Trusts (ever the misnomer) nor BMA put large chunks of money into Tory Ministers' bank accounts.
    It's a decades-long strategy, rolled out with patience. If we care at all for NHS, we have to work out what's happening and what's next, and work out a plan to foil their plan.

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  • Nigel - correct analysis as usual. 3 successive governments have repeatedly and systematically destroyed any of the potential that could have come from the 2004 contract - remember high trust, low bureaucracy? remember 'no new work without new money? agreements repeatedly reneged? And now, a token reimbursement of expenses yet to come - no mention of expenses past. Meanwhile It is now patients who surely are paying the penance, as well as us. It is not so different from the juniors argument. Exhausted GPs can't do or take any more. Its not safe and its not fair. We must get that simple message out and harness their power. Not just national patient groups, but in every SoMe forum, in every patient participation groupie every surgery, in every waiting room, and yes, in every consultation. One message, One Profession All patients.

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  • Took Early Retirement

    I think Ivan is at least B list and possibly A. I don't agree with some of his analysis but he has a brilliant coiffure.

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  • Vinci Ho

    Would say the same thing about Boris, John. And please stop using difficult word that I had to look up in the dictionary. You know my English is not that good!!!!

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  • Spot on again Vinci. The last financial crisis saw a lurch to the left and intervention in the market. The coming financial crisis will be addressed by a lurch to the right, and allowing 'market correction' (Keynes vs Hayek all over again).

    The impact? Trump & Boris. TTIP. Pound in freefall. 5YFV predicated on a financial fantasy and £22bn in savings looking further away than the moon. Simply, there won't be enough money to pay the bills.

    Austerity v1.0 will look like childsplay. The cuts so far will look like trimming the toenails - v2.0 will look like full scale amputation. Look at the public sector changes in Greece for cues.

    And the evidence:

    So, co-pay? Certainly.
    Two tier system? Yup.
    Loss of the NHS? I think you all know the answer to that.

    The question now: How much of what you are doing currently will surive the paradigm shift? And how much of what you are planning for is predicated on the right model?

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  • Can you explain a difference of £500 per patient or even £200 in a county like Dorset

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