As a working GP I know what it feels like to be told that despite all the efforts the practice makes there is to be no pay rise — indeed, in effect, a pay cut — for the coming year.
Like every GP in the country, I am appalled at the way we are being treated. As chairman of the GPC my task is to see how we can help practices take practical steps to protect the interests of their patients and staff — and of course their own hard-won pay — in the face of an income cut.
GPs all over the UK want to see some action. They are angry that for the second year running there will be no uplift to their funding streams while the stream of work flows on relentlessly. Yet their professionalism shines through, in that the feedback I am getting is that GPs do not want to vent their anger on either their patients or their staff.
So what are we going to do? The GPC is producing a set of actions GP practices can consider taking. The aim is to maximise efficiency and make the best use of available resources.
Many GPs have identified Choose and Book as their first-choice target and it will certainly be included in the Action Paper. But Choose and Book is an England-only system and our colleagues in Scotland, Wales and Northern Ireland are every bit as furious. There are even some GPs who find Choose and Book works for them and their patients. By identifying a raft of possible actions, practices will have a menu to choose from to meet different situations in different parts of the UK.
Areas to be covered will include not taking on unfunded work and managing workload.
If the government wants to play this game of refusing GPs a cost-of-living rise it has to realise that areas of policy that are unpopular will not be implemented.
I believe that GPs will demonstrate to government that they are not prepared to co-operate with new or existing areas of work that do not advance patient care. It is time to show the government that its actions have consequences.
While family doctors will not do anything that damages the interests of patients, there are government policies which many feel do not benefit the men, women and children using the NHS.
We will be encouraging practices to show their staff how much they are valued by ensuring that they get non-staged pay awards.
Along with GP principals, GP registrars, trainers and educators have all taken a hit. To reduce the supplement from 65 per cent to 55 per cent for new registrars is shameful. It demonstrates, yet again, the lack of any coherent workforce planning and will put off young doctors from following a career in general practice.
The derisory increase for trainers and educators shows how little the government understands the needs of the profession.
In all of this there is one crumb of comfort. Contrary to the arguments of both the DoH and NHS Employers, the Review Body ruled that it does have a continuing role to play in pricing the new GMS contract.
We did badly for the year ahead — but unlike the offers we rejected from NHS Employers, tied up with so many strings they looked like a cat’s cradle — at least the profession is not faced with yet more changes in 2007/8.
As for actions, the GPC will provide the bullets; practices must decide how they want to use them.