The acceptance of much of the contract was not wrong in itself, but the negotiators made two fundamental errors.
The first was to relinquish the individual contract. This made obligations and impositions directly upon individual GPs, which although requiring considerable commitment were safeguards for the job in the future.
The second mistake was to give up responsibility for out-of-hours care. Although intolerable to some, this the government and public valued and it would have been our most useful long-term negotiating tool.
The income of any particular group of workers will reach an equilibrium dependent on the number of individuals available and willing to do the job, the perceived usefulness of the job and the availability of an alternative workforce. Negotiators need to pay strict attention to each of these points.
There is no doubt that general practice has become much easier than previously. This is illustrated by the larger number of GPs, in particular those without a full-time commitment. In the long term, this will inevitably result in a reduction in income; it would be foolish to think otherwise.
A return of some sort of commitment to working antisocial hours may be no bad thing.
Like anyone else I do not like a cut in my income. Negotiation with the government is, however, a long game and we are about to pay the price of expediency.
I am not a negotiator and whether this was done with or without insight I do not know. But it would be prudent to minimise the negative but inevitable consequences of the 2004 contract and get on with the job.
Dr Ian MacGregor, Stenhousemuir, Stirlingshire.
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