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GPs go forth

We need a new referendum on Engtry


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Surely it’s time for a vote, right? The clock is ticking, we’ve been plunged into uncertainty and the future of our part in a great federal union is at stake.

No, not Brexit, stupid. I’m talking about the new GP contract. So, Brentry. Or, more specifically, Engtry. Because the irony is that, as the country’s on the brink of crashing out of one federation, we GPs are being herded into another – the brave new world of Primary Care Networks.

But as the deadlines approach and details slowly emerge, the deal looks decreasingly attractive, and I never thought it was much of a looker in the first place.

Take a central plank of the new contract – those subsidised staff. That romantic image of a Noctor Cavalry riding over the hill to our rescue is fading fast. The promised funding, we learn, is dependent not only us delivering new network services via seven frankly terrifying national service specifications, it is also subject to a now-you-see-it-now-you-don’t ‘balancing mechanism’.

That romantic image of a Noctor Cavalry riding over the hill to our rescue is fading fast

Plus, one of the rationales behind this bright staffing idea is, apparently, simple availability: rather than fill the Job Centre with redundant pharmacists and social prescribers, use them as square pegs to fill the round holes of the GP recruitment crisis. Nice idea. There are some resting actors about, too, so how about we get them to play noctors playing doctors?

Look, the solution to our malaise does not lie in a few financial inducements, in being corralled into groups or in having irrelevant staff chucked at us for the sake of it. It lies in radical and effective ways of making us less busy, which means putting a hermetically sealed lid on our workload – something the BMA has been talking about but which, on this evidence, it has not delivered.

In 2004, it did just that, via the transformative removal of out-of-hours work. And even then we got to vote on it. So why not now? I think just the single referendum should do it.

Dr Tony Copperfield is a GP in Essex

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Readers' comments (7)

  • You’re just not listening!
    The solution lies in Working at Scale, (useless) initiatives and technology.
    Repeat after me...

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  • If, in 2004, we had, instead, gone to a 'dentist' type of remuneration per unit activity, AND with a payment for OOH work that a *Dentist* would charge, how things could have been different

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  • Or if we had taken the Guernsey Option and left the sinking ship NHS.

    But the BMA are committed to saving the NHS rather than saving doctors.

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  • The Only referendum the BMA/RCGP understand is the withdrawal of your subscriptions.Anyone who hast done that yet must be a can or two short of a six pack.Would be interested to know what happened to BMA membership numbers since the junior Drs strike!

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  • Cobblers

    A SINGLE referendum TC? Nah two or three referenda will have to be done until HMG gets the result it wants.


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  • We should go the dentist lawyers way. After all, it is harder to get into medical school is it not? So why are our leaders herding us down this stupid lane? The doctors need saving not the NHS which really is on life support and cannot be saved due to the amount of abuse chucked at it like all free services.

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  • @ cobblers : have you already forgotten the BMA contract votre for 2004? they only took one vote, but restricted who could vote and re-interpreted the outcome, from a No to a Yes, to save the costs of a second vote. No need for more than one referenda, just manipulate the outcome!

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