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Independents' Day

Vioxx fall-out leaves GPs and patients confused

Is your working life improving?

The contract promised a better working life for GPs. We homed in on seven areas of crucial interest to GPs and asked them how things were going.

The areas we selected were morale, allocations, out-of-hours, workload, recruitment and retention, pensions and pay.

We asked a selection of GPs up and down the country whether things are getting better. Has the contract delivered?

Morale

Dr Chris Hall full-time GMS GP in Belfast

I hoped we would get more recognition for what we did before but weren't getting paid for.

Yes the new contract has helped because it has enabled me to opt out of out-of-hours work. But there are still unresolved issues as to when the out-of-hours structure is going to kick in. The longer that continues the more I fear there may be a loss of morale.

I do still feel like a GP. I think we are treating patients

better, but we won't notice that for a few years. The new evidence-based culture could put pressure on GPs to chase unobtainable targets, but fundamentally I think the new contract is a good thing.

Dr Peter Moore full-time GP in Torquay, Devon

The hope was that we would actually get paid for work we do. GPs have fallen behind

consultants and I don't see why we should be behind them ­ we are equally important in the NHS. We do have our own levels of expertise and 20 years after starting I am still trying to get that message across.

It is too early to tell if the new contract will boost morale. I think the big problem is that it is much more bureaucratic than I had hoped. I felt quite optimistic that we wouldn't be ticking boxes and things would all be taken on trust. In fact it isn't at all.

Having said that, it is the first year and once we get the system up and running on the computer I am hoping it will be easier.

I think stress levels have gone up at the moment. I do appraisals and everybody says the same thing: individually it is all good medicine but we don't have the time or the money to do it.

Traditional general practice is being eroded: I am always made to feel guilty if I am talking to a patient and so running late.

Dr Michael Crawford part-time principal

in Hillsborough, County Down

I wanted less stress from the new contract and recognition that we

were offering a quality service. I don't want the results to be open, but it

would be nice, if we were performing well, to let people know that. People nowadays are very much consumer led and will move around to where they feel they get best service.

I think it has galvanised our team: it has given us areas to focus our minds on. And we are getting a lot more information on the computer now. There was some inertia before.

It will improve practice over the next few years. It is good to have guidelines to follow and any GP who is just ticking boxes is not consulting properly. There has to be a balance

I am very confident that we can improve with the new contract. There are some shortcomings but I never expected it to be perfect.

Dr Helen Joesbury GP in PMS

practice in Sheffield

We are hoping to expand our practice. We have been very

confined by the shortage of resources and are hoping to get some more. Aside from everything else, that would make us feel more valued.

We are not too depressed yet: we are working hard towards quality targets. Waiting now for QMAS. But very glad that we are PMS and so protected from all the hurly-burly.

It is unfair to say GPs are becoming more about tickbox medication. It is about balance. It is good that all patients on four or more repeat prescriptions should have medication reviews recorded.

But when it comes to looking at everybody on repeat prescriptions, that will give us more problems.

But on the other hand I have

found lots of obsolete prescriptions on the system.

Dr Sureshini Sanders GP in GMS

eight-partner practice, Livingstone, Scotland

I never agreed with the new contract anyway. We

are being completely devalued under it.

Training grants have been slashed, budgets have been cut, I don't know what they are thinking.

The contract is not delivering. I am spending more time than I was six months ago on paperwork to prove that I am doing

things, rather than doing the things I am supposed to be doing.

They seem to have an agenda to wipe GPs off the face of the earth. They have

no concept of the holistic care that we give, they think it is

all about NHS Direct. But

life isn't as simple as that.

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