In the line of fire

BMJ 2008; 336 doi: (Published 17 January 2008) Cite this as: BMJ 2008;336:114
  1. Adrian O’Dowd
  1. 1Margate

    Could the increasingly public dispute about general practice opening hours backfire on the profession?

    The latest battleground between doctors and the government is the issue of extended opening hours in general practices—and the battle seems no closer to an end, despite talks last week.

    Tempers on both sides are frayed. The government has launched a consultation on a second, tougher proposal to change the GP contract from April if most GPs vote against the original negotiated offer. This has prompted the BMA to accuse the Department of Health of putting a “gun to our head.”

    The government’s approach, called “antagonistic” by some, has, in combination with the BMA’s refusal to budge, resulted in a very public dispute—one that is potentially damaging to the reputation of GPs, not least because of the way it is playing out in the media.

    Neither of the two options on the table (see box) is acceptable to the BMA, whose main objection is what it calls the government’s bullying approach. Although the extended hours are voluntary, the BMA says that an average practice that chooses not to provide them could lose around £36 000 (€48 000; $71 000) a year. It argues that the government’s agenda is to introduce alternative private sector providers to compete with GPs.

    Richard Vautrey, deputy chairman of the BMA’s General Practitioners Committee, said, “We see [the move to …

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