GPs back original BMA hours deal

What GPs think of the DoH's proposed changes to the GMS contract.

The full findings of GP's contract survey will make uncomfortable reading for health minister Ben Bradshaw.

Last week the MP for Exeter in Devon said that the BMA's leaders 'don't really speak for the profession at large' (GPs back BMA over extended hours row, GP, 8 February 2008).

However, GP's survey of 350 GPs showed that the majority back the deal the BMA put forward in the contract dispute.

Of those polled, 65.1 per cent rejected the DoH's offer of a potential 1.5 per cent income increase for practices to open an extra three hours a week on average.

It also found that 50.8 per cent of GPs polled backed the GPC offer of an extra 20 minutes (15 clinical and five administrative) per 1,000 patients per week and the redistribution of 58.5 quality points.

The latest twist in the saga has now seen the GPC issue a statement that the DoH's offer is better than the alternative. This has been seen as a climb down.

Many GPs see this as a step too far. A Cheshire GP asked: 'Why are we the only profession that has to work harder for a pay rise?'

A GP in Dorset commented: 'I'd quite like my bank to open on a Sunday just in case some day in the future I may or may not want to pop in and ask them something. Do you think the banks would do this if we asked them, sorry, I meant forced them?'

GP revealed last month that the 1.5 per cent increase had 'massive strings attached' and may be for extra work (Hours lead to contract meltdown, GP, 11 January).

The GP survey also found that 76.6 per cent backed the GPC proposal that redistribution of points from the quality framework should include osteoporosis, heart failure and peripheral vascular disease rather than access alone.

Nonsensical

One GP said by email: 'I'm always prepared to work towards clinical targets and personally don't mind working an extra Saturday morning a month but to sacrifice evidence-based improvements for a political target is nonsensical.'

A Birmingham GP said of the rejected GPC proposal: 'This would make the contract more relevant to clinical care.'

A Brighton GP commented: 'This would actually benefit patients rather than politicians.'

GP's survey also found that 63.7 per cent of GPs thought continuity of care would be damaged if practices were forced to open longer.

The merits of the deal are currently being debated at LMC meetings across the UK. GPs from Kent and Northampton LMCs said they would accept the offer but more than 80 per cent of 300 GPs at a Leeds LMC m eeting abstained.

The 300 GPs at a Birmingham LMC meeting last week unanimously rejected the contract offered.

Dr Tony Hillier, the medical secretary of Northampton LMC, said the decision to back the DoH deal had been taken 'very reluctantly'. He said: 'There is still a lot of work to be done and it does buy you a year.

'I don't believe those who say if you accept it will get worse. Next year we are closer to an election and if the government makes the contract worse it will then have 99 per cent of the profession against it, which we don't have anywhere near now.'

GPs at Essex LMC refuse to decide how to vote until they have full details of the DoH deal.

Dr Brian Balmer, chief executive officer of Essex LMC, said: 'The way the government is behaving, no one trusts anyone any more. Any goodwill in GP-land has evaporated.'

Dr Simon Parkinson, secretary of Worcester LMC, said GPs would like to reject both the proposed deal and imposition.

But, he said the imposed contract would not threaten the viability of practices on its own.

'It's about what else comes along, what's happening with the MPIG, where will the Darzi centres go?' he said.

Whatever the results of the GP survey, the GPC has stressed the importance of all GPs voting in its poll.

GPC deputy chairman Dr Richard Vautrey said: 'The only poll that counts and will hopefully be representative of all GPs is the poll of opinion.

'I look forward to hearing the voice of all GPs. I would hope that the turn-out is high.'

Over the next four weeks GPs will have the opportunity to make their feelings known in the BMA poll.

The DoH has set 21 March as its deadline for an answer about whether the profession accepts its deal.

If GPs refuse, a less favourable deal will be imposed and the ball will be very much back in the profession's court about how it chooses to respond.

neil.durham@haymarket.com

GP opinion
What do GPs think about the DoH deal?

'I often work a 12-hour day as it is. If I do more, quality of care will suffer as I will be exhausted'

'This will destabilise the local out-of-hours service as experienced doctors will resign'

'I need a life after 25 years of on call'

'The government's agenda is to win votes from the well-off middle class who rarely need the service but moan the loudest'

'The profession needs to draw a line in the sand about how the new contract can't be manipulated for political benefits at the expense of patient benefits'

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