DoH is using old tricks to back GPs into a corner

It seems the government's new plans for extended surgery opening hours are just what every GP wants - or so ministers are keen to tell anyone who will listen. And the health secretary has written to every GP in England to tell them so.

Furthermore, health minister Ben Bradshaw told the BBC that ministers are concerned 'that the current leadership of the BMA doesn't really speak for the profession at large'.

This must be regarded as an outrageous piece of political spin much more common in the 1970s and 1980s when more than one government was keen to declare that a union leadership's strike call was not what its members wanted.

Indeed, health secretary Alan Johnson will be familiar with the tactic having been the general secretary of a major union himself.

It was that experience as a negotiator in difficult disputes that led to many seeing him as a potential peacemaker at the DoH when he was appointed. Instead, it would appear that his knowledge of how the game is played is being put to other uses.

Of course, this attempt to discredit the BMA flies in the face of much evidence to the contrary. After all the GPC's contract proposals, rejected by the government, included proposals for some extended opening alongside new clinical quality targets agreed with NHS Employers.

Then there are the results of GP's survey which show that two thirds of GPs are against the government proposals, although votes and polls at LMCs meetings suggest some will vote 'yes' because they see no alternative.

And that is the nub of the issue. Everything emerging from the government is intended to back GPs into a corner.

The anti-BMA spin is intended to split GP opinion and increase public pressure for extended hours. The threat of a more draconian set of contract changes being imposed if GPs reject the DoH 'offer' makes the poll virtually meaningless.

Then there is the constant claim that patients want extended hours, despite the lack of any real evidence that it is a major issue for most.

The difficulty is that the GPs' side of the argument rests on the technicalities of staffing, costs and access to other medical services, along with the issues of demand and evidence. Meanwhile, the DoH presents the emotive picture of out-of-touch, fat cat GP leaders thinking of themselves rather than patients.

This is not a debate about patient care or outcomes. This fight is about political expediency and the government being seen to do something, rather than achieving a concrete target. And that makes it a difficult battle for GPs to win.

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