Patients and the new contracts

doi:10.1136/bmj.326.7399.1099

BMJ 2003;326:1099 (24 May), doi:10.1136/bmj.326.7399.1099

Editorial

Patients and the new contracts

Contracts excluded the patient's voice and lacked an intellectual overview

The first 150 words of the full text of this article appear below.

It is said that behind every disagreement there are the bonesof an old philosophy rattling around. Surveying the wreckageof the consultants' contract,¹ and seeing also that the generalpractitioners' contract^2–4 is floundering in heavy seas—suchthat even if it is rescued⁵ it will start life half drowned—hasmade us wonder what has gone wrong with the process of makingcontracts for doctors. We want to look deeper, to open out more fundamental debate about what medicine could and shouldbe for, and so what should and should not be in doctors' contracts.

Doctors and managers historically have prided themselves ontheir pragmatism rather than their philosophy. Getting thetask done has been more important than asking whether the taskis valid in the first place. To the negotiators from the BMA,the Department of Health, and the NHS Confederation, settingout in 2001 to draw up a contract . . . [Full text of this article]

Peter Davies, general practitioner

Mixenden Stones Surgery, Halifax HX2 8RQ (npgdavies@doctors.org.uk)

John A Glasspool, general practitioner

Victor Street Surgery, Shirley, Hampshire SO15 5SY (churchwarden1@btinternet.com)

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