Dr Kailash Chand: DH must stop bullying GPs over contract

Who among us can disagree with GPC chairman Dr Laurence Buckman when he warns: 'The government's proposed changes to the GP contract in England risk putting targets before patients and could seriously destabilise local patient services'?

NHS Employers has consistently failed to appreciate that making GPs feel helpless and ineffectual can have an impact on their health - and on their capacity to continue working.

GPs are under substantial pressure, both financially and as a result of their high workload.

Practice incomes have been frozen for several years and this has led to real net incomes dropping by more than 20% since the introduction of the GP contract in 2004.

Adding meaningless additional workload demands to an already stretched service will simply force a reduction in patient access and quality of care as practices struggle to cope.

The demand in the past decade has risen and is rising by the day. This means extra pressure on finite resources. GPs now have reduced funding and increased workload, and have to implement the controversial healthcare reforms in England. The newly formed CCGs have brought with them an avalanche of paperwork and legal requirements, which are eating away at valuable time needed for the provision of clinical care.

There is considerable anger among GPs. A BMA survey of nearly 8,000 GPs found nearly 90% say they will be less able to provide good quality care as a result of the government's proposed changes. It is high time the DH stopped 'bullying' GPs. Instead, it needs to learn that a culture of targets and bullying is a sure recipe for a poorer service and a demoralised profession.

There is still time to sort out this mess. Armed with the results of the BMA survey and its analysis of the impact of these proposals, ministers can make changes and re-engage with the BMA on a way forward. In Scotland and Wales, the BMA has reached agreement with the respective governments - the question is, why is the DH in England so opposed to listening to GPs on its patch?

  • Dr Kailash Chand is a retired GP and deputy chairman of the BMA.

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