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What will 2006 bring for GPs?

2006 is set to be a landmark year for general practice.

2006 begins with the primary care White Paper and final proposals for revalidation. Then there's practice-based commissioning, PCT restructuring, the new QOF and Choose and Book. We asked a cross-section of GPs from across the UK what their views were about the year ahead.

Dr Michael Crawford, Dromara, Co. Down, Northern Ireland

Everything we read about Northern Ireland is that it's 'awaiting decisions elsewhere'.

I'm pretty positive but I am waiting to see how the Government is going to claw back all the money it's given me over the last year and a half.

Dr Niti Pall, Smethwick, West Midlands

We hope the White Paper will bring a more level playing field in terms of tendering for other practices, as we are hoping we will be able to compete in a market.

We will be trying to make ourselves more patient friendly from a business point of view and are thinking about opening later.

Dr Raymond Givan, sessional GP, Northern Ireland

I'm pretty optimistic about 2006. I gave up being a singlehanded GP at the end of 2004, when I found my practice nurse was making more money than me.

Now I'm looking forward to choosing my work and having more free time. A new year Resolution is definitely to improve follow-up and continuity of care.

Dr Sam Everington, east London and deputy chair of BMA council

I'm a pathological optimist so I'm always looking for opportunities and it's the White Paper I'm waiting for.

I really hope it opens up opportunities to do more in general practice in a more integrated way with social care and education ­ an opportunity to provide a lot more and varied services. But there could also be an enormous burden on GPs at the same time.

Dr Tom Coffey, south London

GPs are at a watershed. This year is going to be a key year where we show we are value for money, offer holistic care and are not a service that prevents patients from seeing us.

Are we able to live up to the historic position or do we become like the US where we are seen as financially greedy, providing a limited service?

Dr Alan Middleton, Fowey, Cornwall

Choose and Book may apply to inner-city areas, but it's not suited to rural or isolated areas. I'd much rather see the money being spent on delivering patient services locally.

Such changes will lead to an awful lot of GPs leaving primary care. It's got to the point where I've had enough.

Dr Geth Jenkins, Leicester

I'm looking forward to early retirement on the golf course with a full pension. We'll have to see how realistic that is though.

I'm interested to see what will happen with practice-based commissioning. I want to see if will truly happen or if it will be watered down.

Dr Andrew Buist, Tayside

2006 will be very difficult. Health negotiations have been tough and the Government have had to claim back some of that [lost] ground.

I'm hopeful that in Scotland there will be increased understanding of what general practice is about.

Dr Robbie Coull, itinerant locum

It's going to be very difficult to predict. It depends on how long Patricia Hewitt lasts.

I'm carrying over my two catchphrases from last year ­ 'institutional corruption' where the targets will continue to corrupt the system, and 'presentational politics' where it's not how things are that matter but how things appear.

Dr Dermot Ryan, Loughborough, Leicestershire

It's going to be a year of continuing confusion, bewilderment and demoralisation.

There will be further disintegration and dumbing down of the health service coupled with the increasingly raised expectations on behalf of the patients.

Dr Paul Kettle, Hoy, Orkney

I hope I see a Renaissance of GPs as generalists being developed and valued.

I look forward to the development of remote and rural GP surgeries, particularly in Scotland. But being realistic, I fear that none of this may happen and by the end of the year I may be out of a job because of a problem with Orkney and the island's GPs.

Dr Ruban Prasad, chair, South Lancashire LMC

After two years of a new contract a lot of GPs are expecting to retire. Almost more GPs will retire than there are people to replace them.

It will make or break GPs as far as manpower is concerned.

I am looking forward to my retirement after 42 years. But I will miss it ­ it's a privilege to be a GP, not just a vocation.

Dr Alan Begg, Montrose, Angus

I think the QOF will dominate general practice this year.

We will make progress with high achievement and people in secondary care will notice what we're doing. We're able to say to the sceptics we're succeeding in primary care.

Dr Hugh Jones, Gwynedd, Conwy

I don't think 2006 is going to be an outstanding year for the profession.

I'm most concerned about contract changes and having to work extra hours for less pay. I am also sceptical about schemes such as patient choice as they don't seem to be very relevant for an area like ours.

Dr John Givans, secretary, North Yorkshire and Bradford LMC

There's an excess of changes, allocations and instant new ideas.

Many of them have had good intentions but are complicated, incompetent and have been disasters.

It's disastrous the way the NHS introduces things in a disorganised, incompetent, inefficient way.

Dr Sabyabachi Sarker, Liverpool

'I'm not looking forward to it but have to get on with it ­ how difficult it is depends on what comes through the door.

Access and capacity are still a problem ­ there are still not enough practice nurses, community nurses or health visitors. I can't see anything coming up that will make my job easier.

Dr George Rae, Whitley Bay, and chair of Newcastle and North Tyneside LMC

We should try to ensure the values of general practice are not lost with the possible radical changes coming out of the White Paper.

There's going to be competition and commercialisation. There will be threats but there will also be opportunities. I also hope we can get a solution for premises.

Dr Alicia Gozzard, Prestatyn

2006 will be a great year for increasing nurse involvement in general practice. We will be able to offload some of our work onto them.

They can do most of the work just as well as us. I don't think there is any question about that.

Dr Judith Langfield, Bristol:

2006 is going to be a wonderful year for me. I shall be 60 in August and will retire in September.

So all these questions will be completely irrelevant.


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