Dr Kailash Chand, former GP in Oldham, Lancashire and now chair of NHS Tameside and Glossop, remembers the massive impact of the new GMS contract.
Before 2004 we had what I called the ‘John Wayne’ contract. Our attitude had to be ‘I’ve gotta do what I gotta do’ and we worked 365 days a year, 24 hours a day, seven days a week.
But we were exploited by patients and the Government. As a result, the variation of standards in general practice was huge. Some practices were excellent, others were frankly rubbish, and the 2004 contract was a genuine and honest attempt to address that.
But even at that stage there were flaws. It was good to get rid of out-of-hours but in my view even at that time I did not think we should give up total control, and we did not handle the opt-out well.
Continuity of care was the jewel in the crown of the NHS and by giving up out-of-hours we compromised that.
Dr Kailash Chand