Primary care is now at that point. The government is sabre rattling over our pay and hours, and the next round of ‘negotiations’ is likely to include the unilateral imposition of both an extended working day and a reworking of MPIG.
This is the last ditch: the point at which we either make a stand or meekly go home. How can we defend ourselves against a predatory DoH? Few of us will want to withdraw our labour: the government knows this and will use it as a lever against us. In addition, if we do withdraw our labour there are now too many private companies ready to muscle in on primary care: a withdrawal of GPs would serve only to hand future contracts to them on a plate.
But there are more ways of withdrawing our labour than going on strike. Anything that reduces the number of available GPs will put the system under additional strain, especially as a deficit of 1,200 GPs is already expected by 2010.
The one time we can withdraw our labour without worrying about leaving our patients in the lurch is when we retire — and of course taking early retirement has an identical effect to the same number of GPs simply downing tools.
Five years ago we voted on a new contract with specific provisions and conditions within it, including defined working hours, removal of on-call responsibility and MPIG. If there is any attempt by the government to renege on this agreement, I foresee a sharp increase in the number of GPs taking early retirement out of sheer frustration with a lying, devious government.
GPs will not be prepared to work any harder — especially not for a drastically reduced income, as may well happen in a sizeable proportion of practices if MPIG is abandoned or altered.
So let me warn our government, the DoH and our negotiators: GPs are at the end of their tether and will not stand being meddled with.
The ‘G’ in MPIG stands for Guarantee — remember? That’s what we voted on. That’s what we expect to get. Meddle with it at your own risk.
Dr Lancelot is a GP from Lancashire. Email him at GPcolumnists@haymarket.com