Call me naive, but I’d been quite excited about the much-vaunted ‘new deal’ aimed at putting the ‘inspiration and magic’ back into general practice. After all, the last contract that really Made A Difference dumped OOH (hurrah!) and gave us a pay rise (double hurrah).
And this time? I’ve listened to Jeremy Hunt’s speech in its entirety and I’m still wondering, so where is this deal, exactly? Maybe he’s left it in the same place as those 5,000 GPs. But at least we know why there’s been no talk of negotiation with the GPC – there’s been nothing to negotiate. It’s now painfully apparent that this isn’t the real deal as in a renegotiated contract, this is more a metaphorical deal as in, here are your cards from a stacked deck, but you know who holds all the aces.
Picking though the detail offers absolutely no crumbs of comfort. A £10m turnaround programme for struggling practices, given that includes all of us, works out at a hardly life-changing £1,250 per practice. One thousand physician associates by year 2020 won’t even equate to an extra pair of hands per practice – more like two fingers. And £7.5m to train community pharmacists is about £200 per pharmacist, enough for one session on how copper bracelets don’t really work for rheumatism.
But what the speech lacked in credible maths it made up for in ominous statements. This pact requires, on our part – in addition to the usual access/quality stuff – an end to the ‘unacceptably large’ variation in clinical staffing levels. So presumably we can look forward to patient/GP ratios – and maybe even minimum levels of appointment provision – written into the next contract revision. Brilliant idea. That must be the inspiration he was talking about.
Look, Mr Hunt, this should have been so easy. Completely scrap QOF and enhanced services and recycle the money into the global sum, sending out the message that you trust us GPs to get on with our job. Oh, and a couple of extra sweeteners, like a pay rise and the dumping of revalidation. Plus, of course, the CQC being put to a slow and painful death. That would have given you a rejuvenated profession, one which might even have felt motivated to take seriously some of your saner ideas. Instead we have this weird mission statement of recycled policies, vacuous aspirations and vague threats.
So I’m left feeling somewhat stupid that, where I’d expected the cavalry riding over the horizon to our rescue, what I got was Jezza in a clown car. As for the ‘magic’, I think that came in the revealing post-speech Q&A, where, apparently, he said that GPs should move away from the mentality of clocking off at 7pm. Now you see me value GPs. And now you don’t.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield.