The new GP contract did not give GPs a pay rise, but paid them for quite enormous amounts of extra work carried out on the major disease areas like diabetes and heart disease.
The aim of the contract was to address difficulties in retention of existing GPs and in attracting new ones. For many years, the government had reneged on pay awards recommended by the independent Review Body and the profession had fallen far behind comparable professional groups.
The latest furore surrounds evening and weekend opening. Primary care has been compared unfavourably with supermarkets, which open at unsociable hours, but whose prices reflect the costs incurred in so doing. General practice does not charge for consultations. For surgeries to open in the evenings and at weekends would mean a substantial increase in costs which would not be met by additional funding as things stand.
Either the government would have to pay or the patient. Quite apart from the financial considerations, most practices do not have sufficient manpower to take time off during the day to work an evening shift. It would therefore mean that the GP would have to work night and day with no extra resources to pay for staff, heating and lighting.
General practices are small businesses; such uneconomic practices would be unsustainable, quite apart from the stress engendered in those undertaking the work.
Finally, your paper has managed to confuse emergency out-of-hours work with routine and pre-booked evening and weekend appointments. The additional hours GPs are being asked to work free of charge would not impact at all on the emergency out-of-hours service, which incidentally in most areas is provided by pretty much the same individuals as before the new contact started. GPs have in the main not done their own out-of-hours work for many years but have subcontracted it to specialist out-of-hours services.
Could you please take more care to provide a balanced view of general practice and stop singing from some government-inspired song sheet?
Dr Wally R Fraser, Urmston, Manchester.