Practices have received fewer resources year-on-year, the past five years, to provide services.
Further changes to practice resources this year will mean some practices will lose significant funds to support patient care and may have to reduce or stop some patient services.
The current contract introduced in 2004 did not take into account the wide range of services provided by different practices, and so pressure is caused by a levelling down effect.
A document by the NHS West Midlands urged PCTs to 'put a positive spin on this'. In addition, it tells PCTs to consider advising practices to merge, even though patients prefer smaller practices and maintaining a relationship with a particular doctor.
Also, it suggests changing contracts to APMS, which are normally short term and commercially based.
NHS West Midlands seems to have forgotten that it should be promoting good practice, not forcing mergers and contract changes which will not be of long-term benefit to patient care.
We should all be celebrating the high quality care that most practices provide, and work with the few weak practices to facilitate them to improve.
NHS West Midlands reflects a poorly thought-out national policy for general practice. This policy will require practices to spend excessive time meeting 'tick-box targets', depersonalising general practice and adversely affecting patient care.
The consequences of a target-based culture have already damaged patient care in hospitals: Mid-Staffordshire is only the most recent example.
I hope that in 10 years' time we do not look back and regret the passing of the personal, long-term family doctor.
Dr Grant Ingrams, secretary, GPC West Midlands