He explains that those in England wanting GP contracts to be held by clinical commissioning groups (CCGs), a move which could result in local contracts, fuels the possible demise of a UK-wide contract.
The coalition government has already dispensed with the recommendations of the independent Review Body when it revealed the contents of the 2012/13 GMS contract deal last month. The announcement of a 1% pay rise cap for public sector workers in the two years after 2013 in chancellor George Osborne's Autumn Statement last week was also coupled with a new emphasis on local pay deals rather than national settlements.
GP has previously reported the government's aspiration for a new single contract and the possibility of a push for it to be time-limited and APMS-style.
Advantages of a UK-wide contract for GPs include the combined strength of representing the many thousands on GMS. It also provides a level playing field for GPs across the UK while maintaining high standards. Local enhanced services were designed to provide local flexibility but primary care organisations are cancelling these now as funds are short. In such cases a portion of the QOF could be hived off to allow some local flexibility, while maintaining a UK deal.
Last week's GP revealed that CCGs across England are forcing practices to sign 'draconian' legal agreements that could put their contracts at risk.
Dr Johnny Marshall, chairman of the National Association of Primary Care, was right when he argued that what was needed was a 'practice-driven and owned' solution not imposed by the CCG.
GPs may well find that they have greater strength if they stick together under the umbrella of a UK-wide contract rather than venture out in far smaller numbers into the rain of the current economic climate.