Junior doctors: Contract undermines general practice and shows government isn't listening

The imposition of the junior doctors' contract means the future of general practice is bleaker, argues Dr Rebecca Jones.

Along with almost every medical professional in the country, the members of GP Survival were saddened, shocked and angered to hear the news that Jeremy Hunt would be unilaterally imposing the new contract on junior doctors.

Junior doctors have fought valiantly over the last few months, and have been well supported by other medical professionals and the public, so much so that it felt like it was our fight too.

GPs have tweeted, rallied, and picked up the extra work when registrars were striking, so the final insult - that all of this had made no impact on the government - felt personal.   

I think this is because not only we were fighting for our colleagues, but also for our NHS. We were fighting for our patients and their right to have a safe workforce of medics looking after them.

General practice will be next

But underlying the outpouring of sympathetic sentiments and sense of comradery, a swiftly growing panic and fear began to set in. I’m sure I wasn’t the only GP to feel like this was the beginning of the end. The government will be coming for the rest of us next.

General practice has been going through its own tough time. And as the numbers of trainees applying to general practice dwindle this enforced contract will only further exacerbate the problem, as the overall number of students applying to medical school will continue to decrease.

The new contract will also see any trainee who changes specialties start back at the beginning of the pay scale. NHS Employers officials have suggested that 'in essence' there will be pay protection for trainees switching to shortage specialties such as general practice. But details have yet to emerge.

There are many GP trainees who have trained in other specialties, and choose to become a generalist for many reasons. As things stand, this clause of the contract completely disregards the level of experience and expertise that such a trainee would bring with them to general practice.

It will also mean that many trainees with a mortgage and a family may not be able to afford to retrain as a GP. So, tell us again Mr Hunt, where are finding these 5,000 new GPs from? Because they certainly won’t be lured over from other medical specialties, and now I doubt they will be new graduates.

The government is not listening

So the future of general practice becomes bleaker; the biggest revelation that has emerged from this debacle is that our government is not listening to us. I have no doubt that when the health secretary turns his attention to the GP contract, and we complain and protest, we will not be heard - no matter how loud we shout.

And as the plans for the NHS are slowly revealed, when all that’s left are the burning ashes of a once great healthcare system, and the patients begin to shout too, they shouldn’t hold out any hope that they can salvage what’s left.

So where do we go next? I was hoping to end this article on a positive note. But I don’t think I can. With a health secretary who fudges the facts and figures, and who refuses to speak with those who he is ruining, where do we start?

But one thing I do know is that we are all in this together. Whether we succeed or fail in the fight for the future of our NHS, together we are stronger.

  • Dr Rebecca Jones is a GP in Hastings, East Sussex and GP Survival’s trainee and newly-qualified GP representative.

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