The past few years have seen this process end in the same depressing fashion, with real terms pay cuts for GPs. Will this year be any different?
From the BMA's perspective, there is strong evidence the DDRB and the government need to change course. All doctors play a leading part in maintaining quality care in an era of deep austerity. GPs in particular are coping with an unsettled environment, characterised by rapidly increasing patient demand from an ageing population with long-term conditions, and the government's desire to move more care into the community.
Despite escalating workload, GP income has fallen drastically, plunging by 11% in real terms since 2008. At the same time, the gap between GP practice expenses and income has widened by 2.3%.
GP partner earnings, which keep the practice running, now take up 61% of total income. The stark reality is that if we continue down this track, practices will reach a point where they will struggle to deliver services.
I have countered some of the myths in NHS England's DDRB submission. This document presented a baffling picture of general practice, where GPs had less to do and received more funding.
Neither of these assertions is accurate, but it was particularly frustrating that data were skewed to suggest workload is not a problem. GPs are working harder than ever, dealing with 340m consultations a year and 18m patients with long-term conditions.
GPs are doing this job with little recognition and the strain is beginning to tell. A recent survey of GPs by the BMA showed that 86% felt their morale had gone down in the past year.
All the BMA and GPs are now asking for is an end to the cuts in funding, and recognition of the work GPs do, with an income rise in line with inflation.
By doing this, the DDRB and the government will send a signal that they are at last beginning to understand the threat to general practice. The BMA will relentlessly push this argument. It is now up to ministers to start listening.
- Dr Nagpaul is GPC chairman.