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A faulty production line

Clever politics, but is this new contract a good deal for GPs?

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It was classic Cameron. An announcement that he will develop a new GP contract was made on the Andrew Marr show yesterday on the eve of Conservative Party conference.

For this most political of leaders has made GP practices the main battleground of his ambitions for the NHS.

The announcement of an alternative GP contract to rid practices of ‘box ticking and form-filling’ is not a massive surprise – it was hinted at in NHS England documents earlier on this year, but it is still a bold move.

The implication is that the nationally negotiated contract will be held in aspic whilst GP practices are tempted with a shiny new deal. Baubles could include the abolition of QOF payments and the prospect of premises improvements and, presumably, higher funding per patient too.

While PMS funding is being slashed and burned around the country, on the premise of ‘fairer funding’ for GP practices, the Government has come up with the idea of PMS 2.0 – a turbo-charged package to bind GP practices with hospitals and community services.

But the price of opting out of the national contract could be very high. The PM’s obsession - seven-day access - has already been mentioned and I would not be surprised if practices suddenly find themselves tied into new ‘efficiency’ targets, such as reducing emergency admissions and hospital referrals – that have to be met. Smaller GP practices will have to join a larger grouping covering at least 30,000 patients. Continuity of care, finished.

And the whole thing looks very much designed to marginalise the role of the GPC. The chair Dr Chaand Nagpaul told me in August that his strategy in negotiations this year was injecting some ‘stability’ into the national GP contract.

I predict he will be given his wish. But it could mark the start of the fossilisation of the national deal and expect pay freezes for years to come to tempt practices to the other side.

It may be voluntary, but for practices who are struggling to survive this new contract may become a Hobson’s choice. The Government has played its hand very well. All eyes are now on the GPC.

Nigel Praities is editor of Pulse

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Readers' comments (6)

  • Smart moves by HMG - the strength of industrial action is now reduced as well, since they can honestly say they have offered an alternative.

    PMS 2.0 is a good description though. And if they want us to leave the sanctuary of GMS, there must be a catch. Further clever divide and rule tactics that allow the creation of competition between practices, where the PMS2 practices attract patients away from the GMS2 ones. The scale is to create competition, by forcing larger organisations to offer services across patches that compete with GMS practices. GMS won't be killed off but allowed to wither on the vine.

    If you wanted to see the 'new deal' this is it folks. Whether the poison chalice is for those who drink it or for those who don't is yet to be seen.

    BMA = Blindsided Medics Anonymous. The blind leading the blind.

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  • any practice that is struggling should just get out now. why struggle on? resign the contract and locum, or move abroad, or work in tescos for better quality of life.

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  • Do you honestly think that their politics is good?

    They are alienating the profession that they need to carry out their plans!

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  • Ask yourselves what is it you want
    May I make some suggestions
    1 Pride in our work that means time with our patients to take a good history examine them
    Order tests and TALK with them to take them with us
    2 Time to relax and be with our families like everyone else
    3 All the tools we need ie scans etc
    Now tell me where in all this new bullshit
    ls any of the above

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  • Clever politics? Which part of it is clever? Predictable, lacking in detail, unfunded, high-handed... anything but clever.
    Now what would be clever is if we all just gave 6 months notice on our contracts. Forget the indignity and legal complexities of industrial action. We should regain our professional status and worth by simply setting out our stall. If the Government doesn't like it well that's just tough! It's not like they have a surplus of GP's is it? The dentists don't tolerate this rubbish so why do we?

    Comrades- Abandon your cardigan, socks and sandals. You really don't need to look like a clapped out old cliche to be GP. Wear smart clothes and be proud and professional.

    Don't tolerate rudeness and abuse from patients. Would any employee be expected to tolerated the abuse we do as independent contractors? I doubt it.

    Spend some time with and enjoy the love of your family and friends. Then at work you can focus on delivering up to date, efficient care instead of stroking the fur and seeking the love and approval of your ever demanding patients. They really don't care about you.

    The NHS is hopelessly in debt and the Government expects GP's to compensate by working harder and harder. We didn't create this mess and it is not ours to clear up. Leave it to that obnoxious twerp Hunt to sort out.
    (Dr Enlightened of Bromley)

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  • Dr Enlightened, You truly are!

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