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We need a new referendum on Engtry



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Surely it’s time for a vote, right? The clock is ticking, we’ve been plunged into uncertainty and the future of our part in a great federal union is at stake.

No, not Brexit, stupid. I’m talking about the new GP contract. So, Brentry. Or, more specifically, Engtry. Because the irony is that, as the country’s on the brink of crashing out of one federation, we GPs are being herded into another – the brave new world of Primary Care Networks.

But as the deadlines approach and details slowly emerge, the deal looks decreasingly attractive, and I never thought it was much of a looker in the first place.

Take a central plank of the new contract – those subsidised staff. That romantic image of a Noctor Cavalry riding over the hill to our rescue is fading fast. The promised funding, we learn, is dependent not only us delivering new network services via seven frankly terrifying national service specifications, it is also subject to a now-you-see-it-now-you-don’t ‘balancing mechanism’.

That romantic image of a Noctor Cavalry riding over the hill to our rescue is fading fast

Plus, one of the rationales behind this bright staffing idea is, apparently, simple availability: rather than fill the Job Centre with redundant pharmacists and social prescribers, use them as square pegs to fill the round holes of the GP recruitment crisis. Nice idea. There are some resting actors about, too, so how about we get them to play noctors playing doctors?

Look, the solution to our malaise does not lie in a few financial inducements, in being corralled into groups or in having irrelevant staff chucked at us for the sake of it. It lies in radical and effective ways of making us less busy, which means putting a hermetically sealed lid on our workload – something the BMA has been talking about but which, on this evidence, it has not delivered.

In 2004, it did just that, via the transformative removal of out-of-hours work. And even then we got to vote on it. So why not now? I think just the single referendum should do it.

Dr Tony Copperfield is a GP in Essex