To resign or not to resign, or call their bluff?

I have nothing but contempt for the government over its handling of extended opening times. We have an existing agreement on which it is reneging. However - and quite unbelievably to all of us who voted so carefully on the issue - it now transpires that we may not have a legally binding contract after all.

The DoH is holding a gun to our heads: operate their 'deductive bonus' scheme or take an even bigger pay cut. The GPC, caught with its trousers down yet again, is trying to flex its muscles and look competent.

How should GPs react? If we capitulate and accept the government's offer we can confidently await pay cuts every year: MPIG, rent and rates. We will permanently be over a barrel.

Should we resign? The government and the primary care organisations (PCOs) will say thank you very much, immediately award our NHS contracts to private providers and refuse to reinstate us. The private firms will rub their hands with glee, then offer to re-employ us as salaried doctors at a huge pay cut (or else get their doctors from the EU). How many patients will consult us privately when there's a 'free' franchised NHS practice down the road?

Be careful about resigning if you work from PCO premises: as a purely private GP you won't be allowed back into the building.

Our only practical alternative is to call the DoH's bluff and reject the offer. We should tell them, very publicly, that we will continue to operate the existing 'contract' but will not work outside it without appropriate remuneration. The DoH will then implement a pay cut, but at least we will gain the moral high ground and show that we can be neither pushed around nor bribed.

Then we cease providing data to the PCOs, drop all involvement in PBC, boycott Choose and Book, prevent the uploading of summaries to the Spine and wait for the National Audit Office to ask why billions of taxpayers' money is being so prominently wasted. Then we demand reinstatement of our lost profits before even thinking of taking any of this back on.

Finally we must demand the resignation of all remaining members of the GPC's original negotiating team for failing to warn us that although the new contract was legally binding on us, they could alter it at will.

Dr Lancelot is a GP from Lancashire. Email him at GPcolumnists@haymarket.com .

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