New contract for GPs failing to deliver

GPs' new contract is failing to deliver on its promises to improve their working lives, Pulse reveals exclusively on its website today (Friday, 3/12/04).

In the biggest survey of family doctors' views since the introduction of the contract in April, GPs reveal they are working longer and harder and feel less able to manage their workload.

Of the 1,110 GPs surveyed by Pulse/NOP, 83 per cent say they are working harder, 72 per cent are working longer and 71 per cent feel less in control of their work.   The results are a blow to the BMA's GP contract negotiators who had hailed the deal as a 'turning point' which would allow GPs to take more control of their workload.
 
More than one in four family doctors (26%) say they plan to retire earlier because of the contract. And although 80 per cent of GPs voted in favour of the deal in a ballot in June 2003, some 44 per cent now say they preferred their old contract.

GPs also revealed concerns over new out of hours services and whether the contract was helping improve the quality of patient care.
 
Some 79 per cent of family doctors say problems exist with new out of hours services, with 21 per cent saying the quality of the service in their area is low.  The contract for the first time allowed GPs to give up 24 hour responsibility for their patients, with Primary Care Trusts taking over. Nevertheless, 44 per cent of GPs plan to work night and weekend shifts for new out of hours organisations next year.

Overall, one in three GPs think quality of care had improved because of the new contract. This compares with 15 per cent who say it has got worse.

When asked whether trying to earn money through the contract's quality framework - which pays GPs according for hitting specific quality targets - is improving the care they offered, 53 per cent say it is making no difference. 

Nearly four out of five GPs (79%) say the contract has created a 'tension' between meeting patients' needs during a consultation and trying to earn extra pay for meeting the quality targets.

Overall, women GPs, doctors in small or singlehanded practices and those in inner city areas were most negative about the contract. Younger doctors and those in larger surgeries held the most positive views.

-----------------------------

countrydoctor comments

The editor of countrydoctor, as a BMA Council member, has watched the development and negotiation of this disastrous new GP contract closely from the beginning .  He has been steadfastly opposed to it on the grounds that it would break up and destroy family practice whilst at the same time increasing the GP's workload and delivering the profession into the hands of the government.   On the other hand, it might, just might, increase the income of those colleagues who are prepared to increase both their work-load and their practice administrative staff to concentrate on achieving "brownie" points.

Regarding the  conduct of the negotiations,many readers will recall the occasion when the grand formula, destined to deliver a world of gold to each and every GP, was about to be announced to the assembled media by the then Chairman of the negotiating team.   It was only immediately before that press conference and the special LMC Conference that the Chairman was vigorously informed by hordes of more switched-on GP colleagues that they would, instead, be losing ten of thousands of pounds each.

Astoundingly, no heads rolled.

Then there was the occasion when a Special LMC Conference ordered the team to look more closely at their efforts immediately went their own way.

And how about the chairman who told the world that he would only go for a vote when he knew he would win?

And then what about the many Roadshows which were skilfully crafted to persuade GPs that the contract was the best thing since creation and that any alternative would be the end of general practice?

And, even more damningly, what about the plain, brutal fact that the vote was invoked, with promises and assurances, before the contract was complete let alone priced - and it still isn't complete.

And so it went on.

So, it comes as little surprise to learn that eight out of ten colleagues are working harder and longer.   If they are like the editor they must feel betrayed by those in whom they have put their trust.

Outsiders will be amazed that many of the same team who delivered this dangerous and failing contract remain in office.  No doubt further havoc will be created.

(4/12/04)