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What will happen to GPs' income after three years?

Many of us will be quite impressed by how much money is on offer for the first two years as preparation payments, income protection and aspiration and achievement payments. At least half of us will therefore congratulate the GPC.

There is, however, absolutely no promise or even indication that this windfall will continue beyond two to three years. What will total Government expenditure on primary care be in 2006? Will they still be paying off the costs of another Gulf War? How much of the primary care budget will be swallowed up by paying a realistic price for out-of-hours?

The GPC themselves are fully aware of this inherent weakness. There will be no agreed intended remuneration (the concept has been abolished). We have to rely for future income on the Review Body and the idea that 'it would be politically unacceptable for the Government to reduce GP income'. If you want to know more have a look at the GPU website ().

Vote Yes if you must, but be prepared to start the whole painful process again in three years' time.

Dr David Maconochie

Street, Bristol

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