80% of GPs see end to UK-wide contract

Four GPs in five expect an end to the national contract before the end of the decade, according to an exclusive GP survey.

The survey also found that more than a quarter expected to alter their opening hours and just 16 per cent felt optimistic about the future.

The survey, concluding a series of articles looking at general practice in 2010, found that 79 per cent of GPs expected regionally negotiated enhanced services to herald a wider renegotiation of a devolved GMS contract.

GPC leaders said that such a move would not be desirable but that it was a possibility. GPC chairman Dr Hamish Meldrum said that the GPC was aware of the problem that government devolution presented to maintaining a UK-wide contract.

He said that future elections in the four countries could also trigger changes because different political parties could be elected to govern different areas.

GPC Wales chairman Dr Andrew Dearden shared his fears, saying that separate governments ‘would present different tensions’ and were ‘the greatest danger to a UK-wide contract’.

He said: ‘In reality, enhanced services allow as much flexibility as any government needs — there is nothing they could ask for that  enhanced services could not provide.

‘But the DoH in England doesn’t see the benefit of a UK-wide contract and pushes political rather than clinical aims.’

However, both he and Dr Meldrum agreed that a UK-wide contract should remain and Dr Meldrum added that the GPC was committed to it because GPs deserved similar rewards for similar work and ‘the public should get a similar level of care’.

‘But we are not blind to devolution,’ he added.

The survey also looked at whether GPs were losing their leadership role in the NHS. A similar figure of 77 per cent thought this was the case, and a strong correlation between the answers showed that GPs expecting a devolved contract were most likely to feel there was declining influence of GPs in the NHS.

In more detail, the GP survey looked at what changes needed to take place within general practice. Twenty-seven per cent foresaw the need to extend or alter surgery opening hours.

However, the most widely anticipated change, by 60 per cent of respondents, was the need to form co-ops or other groups to bid for NHS work — a trend that has been particularly focussed in recent months by the introduction of practice-based commissioning.

Fifty-one per cent saw a need to create more partnerships and 38 per cent saw a greater need to take on work traditionally done in secondary care.

Dr Meldrum said that he could understand the commercial drive behind the need for GP groups and longer opening hours but that he had no intention of looking at contractual change to the hours GPs worked.

GPs see the influx of private providers as the most pressing issue for the profession, followed by maintaining profits and the potential for loss of professional status. Although the third of these was the most important issue to the highest number of GPs (24 per cent), many did not see it as important at all, meaning it only came third on average.

The survey also found that 44 per cent were pessimistic about the future and just 16 per cent optimistic, but with 40 per cent somewhere in between, the jury is still out on what general practice will look like in 2010.

GPs predict...
The biggest issues facing the profession between now and 2010:

  • Private providers.
  • Maintaining profits.
  • Loss of professional status.
  • Pension reform.

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