The proposal to reduce income by £6,000 per GP, with the only means of 'earning it back' by working additional hours, is insulting and demoralising.
Encouraging patients to expect GP services in the evenings and weekends can only work if more GPs, practice nurses and back-up services are provided.
If we see patients for routine, rather than urgent problems - as urgent problems should continue to go to the out-of-hours service - in the evening, they will become aware that we are 'open' and start turning up with urgent problems. It would not be possible to turn them away, and workload would increase further.
Most of us have lives outside of general practice; working from 8am-7pm is enough. Extended hours must be additional hours and, if we are not to work them personally, we must employ others to do them for us. This is not feasible.
So, we have made a business decision to lose the DES income by not opting in. We will attempt to reduce our expenses perhaps by natural wastage of staff when they leave, and by other means, which may mean reduced services to patients.
Of course if you ask patients if they would like us to be open in the evenings or at weekends some will say 'yes'. However, most employed patients are able to take time off to see their GP.
The majority who attend regularly are children, elderly or not working as a result of their medical problem.
It is a small minority who wish to come in during the 'extended hours' period. We do not receive complaints about our hours of availability.
Dr Tony Kaye, Davyhulme, Manchester.