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1% is peanuts, but it is all part of Hunt’s grand plan

The rumours were true. The new contract brings little to make a big difference to the hole general practice has fallen into.

There are some welcome developments – binning the controversial dementia DES and no changes to the QOF – and an actual inflation-busting 1% pay uplift is welcome. 

For the first time in many years we also see a real effort to address rising practice expenses, with an additional 2.2% to cover recent hikes in indemnity costs and employers’ national insurance and pension contributions. After nearly a decade of pay cuts, I guess GPs have paid their ‘penance’.

But this is all pretty small-scale stuff when you consider the massive problems with recruitment, the rising numbers of patients displaced by practice closures and the devastating impact of cuts in MPIG and PMS funding.

Jeremy Hunt is playing the long-game 

And there are some potentially significant pieces of additional work that are buried in the small print. Practices ‘will aim for’ at least 10% of registered patients to be using online services and will have to record data on evening and weekend opening hours and ‘the number of instances where a practice pays a locum doctor more than an indicative maximum rate as set out by NHS England’. Sounds ominous.

All the rhetoric about putting the ‘inspiration and magic back’ into GPs’ working life looks a little bit hollow.

But I get the sense that the health secretary wants it this way. He wants to engender a sense of dissolutionment before he comes in, superman cape fluttering with a lovely pert ‘package‘ of measures that will ‘save’ general practice.

He wants to make the national contract look like a bag of the proverbial as it suits his longer-term aim to undermine it and introduce his own sparkly seven-day ‘voluntary’ GP contract to push forward his manifesto agenda.

Watch as GPs are promised extra funding in return for a whole list of new responsibilities that will make Mr Hunt’s boss in Number 10 very happy and will suit perfectly the aims of the Five-Year Forward View.

I may be wrong, but I sense Jeremy Hunt is playing the long-game here, and the forces are being gradually lined up to divide the profession and side-line the BMA and Labour’s maligned 2004 contract.

For some GPs this will be a welcome release from the constraints of the current system, and in the short-term it could prove lucrative for practices to make the leap and start to form a truely primary care-led NHS, but there will be no going back once the genie is out of the bottle.

A similar game was played with the juniors, now it is GP’s turn.

Nigel Praities is editor of Pulse

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