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Why you have to vote No

Phil is fuming over the Government's gunboat diplomacy and fearful for the future of general practice.

Phil is fuming over the Government's gunboat diplomacy and fearful for the future of general practice.

We stand at a crossroads. The future of British general practice lies in our hands. Shortly, the GPC will ask us to vote on what is laughingly called the choice offered by Her Majesty's Government. In HMG's own words, it's not a choice, it's an imposition.

The arrogancia from the Department of Health have rocked up to the negotiating table with one proposal: ‘Do these extra hours for nothing. In fact, do them for a loss of income. If you don't, we will unilaterally change the terms of your contract and you will lose even more – £37,000 a year for the average practice.'

There was no negotiation. The fact the GPC was prepared to concede two extra hours of opening time for less than it would cost was neither here nor there. They were not interested. Our GPC felt unable to accept the imposition. Now it is asking your opinion. How does this situation offend me? Let me count the ways:

1 For more than two years now we've been systematically vilified in the press. ‘Fat cat GPs' has been the intellectually lazy rallying call. We've never really understood why, until now, when it all becomes clear.

2 The department has invoked the three-month ‘unilateral change in contract' clause that was designed for a national emergency. It wants three extra hours of surgery time instead of the offered two. What numpty would classify that as a national emergency? Some 86% of the population are entirely happy with their access to general practice, 34% are entirely happy with the quality of Government they receive. Guess which one they intend to change.

3 While our Government bleats hypocritically about improving the quality of primary care, this latest proposition exposes their cant. Money is to be diverted from genuine proposed QOF changes, such as care of osteoporosis, into this bogus vote-catching cynical directive to extend opening hours.

4 This is a direct contravention of the terms of the 2004 contract – that new work should be supported by new money and new resources. This was explicit, as was the agreement that care ‘out-of-hours' would be the responsibility of the PCT, in return for a cut in income. None of this apparently means anything now.

5 Who on earth treats a respected profession with such disdain? How dare they show such disrespect to our elected representatives? Even the miners in the 1980s were offered a platform for negotiation. What does this tell us about how we might expect to be dealt with in the future?

Bullying tactics

Vote Yes and you are effectively sounding the death-knell for general practice. A Yes vote might be financially the least worst option in the short term, but it's also a tacit acceptance that our Government's bullying tactics are acceptable to us. A Yes vote is a mandate for those envious, unpopular, incompetent, corrupt sods to come back year after year, to erode the MPIG or increase OOH commitment or do whatever the hell they want. Why would they not, faced with such limp-wristed opposition? ‘You agreed,' they might tell us.

A Yes vote would condemn us to eventual salaried servitude in the employ of Richard Branson and his ilk. It would make our hard-won expertise merely the damage-limitation service for the errors of underqualified inexperienced berks. Do you want to see your practice absorbed and destroyed by giant Darzi polyclinics? Do you wish to see continuity of care and personal long-term involvement with patients and their families submerged in the responsibility-dodging quagmire of nurse-led walk-in centres and polyclinics?

You have to vote No. Reject this shameful Government's supercilious treatment of our profession and disregard of effective patient care. Reject its ‘foot-in-the-door' approach to cynical big business involvement in primary care.

This is a Government that invests just £100 per year in the primary health care of each citizen – 10% of the sum it has committed for each and every one of us to bail out Northern Rock and less than it costs to insure a hamster for a year. Can you credit its incompetence?

A profession ceases to be a profession once it is no longer self-regulating and self-determining. You are going to take a financial hit whichever way you vote, but a No vote is the only way you retain a voice in the future of a profession in which you have invested your expertise.

And you can't put the decision off. Now we are indispensible to the Government. In another year, there will be more polyclinics and more walk-in centres and more disillusioned disenfranchised unemployed doctors with no choice but to take a job, in the absence of a vocation.

It is literally a nightmare that a so-called Labour government should be the architects of both the formation and the dissolution of that proud dream, the NHS. Don't let them piss it all away. They do not have the right or the mandate. Stand up and be counted. Vote No.

Dr Phil Peverley is a GP in Sunderland


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