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A faulty production line

Another day, another contract

Copperfield 

Another year, another 86-page contract update to plough through. That in itself would be enough for the change-fatigued to jack it all in. Let’s press on, though.

Pre-contract negotiations, it was hard, wasn’t it, to imagine what ‘victory’ might look like? Though, given the absurdity of the draft service specs, it was obvious we were anticipating some kind of win, as things could only get better. So is the trumpeting around the contract revision justified triumphalism, or a collective and protesting front-line fart? Well, let’s look at those headlines:

  • More roles added to the additional role reimbursement scheme! Now featuring, wait for it, care coordinators, health coaches, dietitians, podiatrists, occupational therapists and pharmacy technicians. So that’s staff we already have access to, staff we don’t want and staff we’ve never heard of.
  • One hundred per cent reimbursement!! In case you’ve forgotten already, that applies to staff we already have access to, staff we don’t want and staff we’ve never heard of. It’s like being given free air.
  • More doctors in general practice!!! Apparently, 500 extra trainees working for 24 rather than 18 of their 36 months in general practice represents ‘one half’ of the 6,000 extra doctors provided. Despite being supernumerary, right? You might want to check the maths on that.
  • Improved service specifications!!!! The blurb proclaims that those horrific specs have been whittled down to just three pages. Amazing what you can do with a smaller font. As far as I can tell, words have been arranged and wriggle-room added, but the song remains the same.
  • A £20,000 one-off incentive payment for new partners!!!!! Because that’s the barrier for prospective new partners, isn’t it? Fears around crushing responsibility, crippling workload and the prospect of ‘last man standing’ are nothing in the face of an envelope stuffed with used fivers.

For every one who says, ‘That’s good,’ there will be many more saying, ‘That’s it.’ With trumpets

And so on and so forth.

The most depressing thing here is that, once again, the point has been missed and the direction of travel set. The problems paralysing general practice are too much work and too much responsibility. These are not solved by giving us more of each. I’m exhausted, and there is no way that pseudo-help and arms-length bribes are going to help.

A few may be seduced by the shiny new package. But for every one who says ‘That’s good,’ there will be many more saying ‘That’s it.’ With trumpets.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

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Readers' comments (8)

  • Not just me then

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  • totally agree. the care home DES still requires an MDT meeting each week for each home and £120 per pt does not cover the cost when you are covering 100 residents across ten different homes.
    ten separate MDTs? again this is more work for GPs with no remuneration and just reimbursement of staff who are neither available or qualified for the work required.
    Reject the contract or opt out the DES I say

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  • dump it

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  • agree dinv its still just a polished turd.

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  • Sadly our union would rather we all died from overwork rather than we do the obvious and leave the NHS.

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  • just say no

    or go salaried

    or resign en masse offering your own contract

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  • " I’m exhausted, and there is no way that pseudo-help and arms-length bribes are going to help"

    100% correct

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  • Spot on as usual. "Words have been arranged and wriggle-room added, but the song remains the same." says it all.
    Don't forget giving with the left hand and taking with the right by pension tax, stamp duty etc moving to an area of shortage. OOH going to be dumped on us, more useless work with the homes. The amount of staff needs an additional manager and taking on staffing risks you would otherwise not have. Really "helpful". Just to make sure it does not pay to help like Dr Bawa Gaba, when things go wrong, they will blame you working under so much stress.
    Not just striking one off the register but Gross Negligence Manslaughter, punishment that is almost equivalent to intentionally stabbing someone. It really does "pay to help". Pay with our lives.

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