This site is intended for health professionals only


The twisted logic of the ‘New Contract’



Another day, another promise/threat of a new contract. This time, it was announced by David Cameron during Andrew Marr’s news-driven chat show – appropriate because it was news to the GPC, and they’d probably like to have a chat about it.

It’s interesting to scrutinise the exact wording of DC’s announcement. In case you missed it, he said: ‘I don’t think anyone is happy with the GP contract, so this new contract will focus on making sure that people in our country can get access to a GP on seven day a week basis, 8am to 8pm, that’s what we want to see.’

The Government has a vision. They know what they want to see. And one way or another, they’ll see it.

As an exercise in knight’s move thinking, it’s quite breathtaking. Consider its three parts:

a) ‘I don’t think anyone is happy with the GP contract’. Clever, a classic Cameron ‘We’re all in this together’ opener, seducing us into thinking that everyone’s on board from the outset.

b) ‘So this new contract will focus on making sure that people in our country can get access to a GP on seven day a week basis, 8am to 8pm’. How can a) get to b) via ‘so’? It can’t, because it’s a complete non sequitur, yet it appears it has. In other words, he’s saying that no one’s happy with the contract, so he’ll sort out a new one that no-one other than the Government needs, wants or will be happy with. And he’s saying it as though it makes some kind of sense.

c) ‘That’s what we want to see’. Though we’ve inexplicably jumped from the inclusivity of ‘everyone’ in the opener to the more exclusive ‘we-as-in-Government’ in the sign-off, there is at least a sense of twisted logic here: the PM is acknowledging that, while what he’s saying might be drivel, it’s exactly the type of drivel they’re after.

Don’t fret if you find all that rather confusing. Because the words with real clarity and import came, at a Tory Party Conference session, from the Health Secretary rather than the PM. According to Jeremy Hunt, ‘Labour signed a disastrous contract in 2003 and since then, in penance really, the NHS has not really wanted to put extra money into general practice’. So there you have it, as if you didn’t know already. Twelve years ago, we negotiated in good faith a deal which, at the time, saved many in the profession from burnout, improved quality of care beyond any politician’s wildest predictions and helped boost flagging recruitment. And we’ve been persecuted for it ever since.

Whether Dave’s new ‘New Contract’ will be further punishment along similar lines, or a tempting juicy carrot, time will tell. But one thing’s clear. The Government has a vision. They know what they want to see. And one way or another, they’ll see it.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield