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LETTERS: James P Bell, Simon Fellerman, Prit Buttar, James Cave, John A Glasspool, G Rhys, and Peter Davies The fresh new contract for general practitioners BMJ 2002; 324: 1274 [Full text]

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GPC show lack of objectivity

Steven B Nimmo   (25 May 2002)

Thumbs and the New Contract

Jeremy J Vevers   (26 May 2002)

New GP contract

Martin Roland   (27 May 2002)

GPC show lack of objectivity 25 May 2002
Steven B Nimmo, GP Principal, Barton Surgery Horn Lane Plymstock, Devon PL9 9BR Send response to journal: Re: GPC show lack of objectivity	I have been very disturbed by the lack of objectivity demonstrated by the GPC negotiators in the presentation of the new GP contract framework to the profession. While it has its good points there are many valid criticisms including the failure to address demand management and the government retaining the right to unilaterally impose change. The GPC have singularly failed to present a balanced view and I feel that we are being railroaded into voting for this contract. I am also disturbed that they continue to refuse to allow us to see the alternative models that they have considered. This kind of patrernalism is unbecoming of the elected officials of our trade's union.
Thumbs and the New Contract 26 May 2002
Jeremy J Vevers, GP /PCT PEC deputy chair Moatfield Surgery: RH193GW Send response to journal: Re: Thumbs and the New Contract	Sadly thumbs are involved in this stage of the evolutionary process that is our new contract. A complex document that was about addressing recruitment will leave us looking divided and our negotiators fundamentally out of kilter with their constituency. This in itself will do nothing for recruitment and could leave our negotiators looking silly and impotent. One of the attractions of general practice has been the ability to "drive your own bus", to build individual and long lasting relationships with patients and to be part of a community. Evidently this is no longer appealing to young doctors. They do not want millstones round their tender necks. Much of this is about education, apprenticeship and how we as a branch of the profession have not looked after our own. We expect government to do this and are then surprised when they govern. PMS was one of the central initiatives that could have helped. It asks for enthusiasms and agendas that are locally driven. It panders to that bit of us GP's that want to be back in control of our destiny. The BMA, however, have long espoused the "wisdom" of centralised negotiations. Over pensions they may well be right, but they are by definition committee people. Their enthusiasms may well have changed from the time they first went into general practice. So whilst PMS informs some of the essential framework of the New Contract it completely fails to see that there must be devolution of responsibility to localities. This will require trust from central government that we know what we are doing and that budgets will be effectively managed when we have the fire back in our bellies. The enthusiasm would return and be infectious. The new recruits would flood in. Alas this is unlikely to happen for a long time to come. Our profession will be seen by government, the public and medical students as deeply fractured and despondent. Those of us in our fifties will be longing for retirement. What a waste. The way out of this could come if the BMA now listen to those of us who care about general practice and use that to inform the next phase of negotiations and do not see this as a binary decision. The next phase would take time and trust. Sadly the last may be in short supply.
New GP contract 27 May 2002
Martin Roland, Professor of General Practice University of Manchester, M13 9PL Send response to journal: Re: New GP contract	Peter Davies (letters 24th May) points to the silence from academic GPs on the new contract. I did offer an editorial to the BMJ, but Lewis and Gillam got in first - you will have to wait for the July BJGP to read mine! I am in favour of the new contract. For too long, we have been penalised for providing good care - i.e. paid more if we had large lists and few staff. I am delighted with a contract that will pay me more if I provide a first class service. The pricing is, of course, crucial, but the principles have to be good. So let's vote 'Yes' in the first round, and then look at the pricing critically. It is interesting that letters to the BMJ about the 1966 contract were about 90% against. With the hindsight of history, the 1966 contract was clearly the salvation of general practice. I think the BMA negotiators are being equally far sighted in 2002. Martin Roland