VIEWPOINT FOR 20 MARCH
FROM DR RICHARD TAYLOR

There is understandable anger and indignation among GPs that an agreed contract between their negotiators and the Department of Health should be altered unilaterally as it appears that the Department has only recently woken up to the consequences of the contract for evening and weekend working.

The new contract enabled good, forward looking GPs to engage much more with programmes to help the elderly, those with long term illnesses and the disabled. General practice in our area is excellent and so I have not been surprised to receive many letters from constituents, not in favour of the Government's demands for weekend and evening working but supporting the GPs' resistance to this pressure. This is borne out nationally as an Ipsos Mori poll of 2.6 million people found that 84% of patients were satisfied with the current opening hours of their GP practices.

At a meeting on 22 February with representatives of our GPs I was told clearly that they objected to the way the Government was forcing the extended opening hours on them without considering the consequences. 

• For instance they query the effects on non medical and nursing support staff and on the quality of existing services for the elderly and chronic sick. 
• They do not think people realize that a surgery will only be open at the extra times for booked appointments and not for other purposes such as emergency drop-in or prescription renewal. 
• How do they prevent patients dropping in inappropriately? 
• Will the employment of nurses for nurse appointments be included and qualify as part of the extended hours to fulfill the new obligation? 
• If two GPs are working will the extra commitment in hours be halved?

Local GPs summed up their objections telling me that they feel the proposal is for routine care for the most able minority at the expense of the most vulnerable and that it will reduce day time opportunities in other areas such as teaching and health promotion.

They were also clear that they had to agree to the Government's proposal as the alternative was worse. 
I understand that there were 27,469 responses to the nation wide poll of family doctors and that 96% said that they were opposed to both options but had selected the Government's proposal as the 'less worse' option.

The greatest concern among GPs is the threat to general practice as we have known it since the foundation of the NHS from private sector providers who will have to make profits for their shareholders. 
GPs are concerned about the new privately provided GP walk-in centres foisted on each PCT regardless of the need in a particular area. They believe these also are ill-thought through ideas with unforeseen consequences for patients.

I fear that some people may believe that the actions of GPs are based on protectionism but I have worked with large numbers of GPs for many years and I know almost all of them are dedicated solely to provide the best, continuous care for their registered patients.

R.T.