Editorial: Why there's no need to repeal the contract

When it was suggested this month that the profession should lobby to repeal the current GMS contract, it sounded like a slightly crazy idea.

It was reminiscent of the 1983 Labour Party manifesto with a clause that threatened to nationalise banks that did not fall into line - who would have thought it could ever happen?

But, of course, a fortnight is a long time in medical politics, and now there are rumblings that maybe it would be better for GPs to start from a clean sheet.

Professor Allyson Pollock suggested the repeal - though it sounded more like a plea - at the RCGP conference in Bournemouth recently, where Dr John Chisholm was also speaking (page 17).

Dr Chisholm has kept a low profile since stepping down as chairman of the GPC, following his negotiation of the new GMS contract on behalf of the profession.

He told the conference that the contract had brought good and bad things to general practice - which is a shame because he had originally claimed that it would spark a 'renaissance' in the profession.

Having said that, perhaps no one could have foreseen the smash-and-grab tactics of successive ministers since the contract was first agreed.

Any benefits for GPs were quickly clawed back, using both lawful and unlawful means. Those practices on PMS contracts have also been cast aside, having apparently served the government's purpose of dividing the profession.

The quality framework stands out as probably the most successful element of the contract, but even that is still a work in progress, open to abuse by politicians, and now likely to be smothered by NICE.

So repealing the GMS contract is probably not such a crazy idea after all. In fact, if you add up all the changes over the past year, then this contract has been well and truly torn up, trampled on and burnt down.

In many ways, there is no need to repeal new GMS because it has already been done - by the government.

More opinion online

Read more opinion from the GP editorial team in the editor's blog at www.healthcarerepublic.com/blogs. This is what the team had to say this week.

  • "To experience what it is like to have COPD, we were asked to hold our breath, then to breathe lightly, walk on the spot and pick up an imaginary grandchild. It demonstrated the point well, though I felt silly participating in a group breathing exercise."
  • "Reports say Peter Mandelson's spokesperson confirmed he was treated as an NHS patient. I am not sure why, but I am struggling to believe this. Perhaps it's the fact he was treated for his kidney stone in less than 12 hours."

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