GP contract delivers on just two of 13 government aims
BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39504.525301.4E (Published 28 February 2008) Cite this as: BMJ 2008;336:465
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I am no longer a GP partner but was when the contract came in and up until 2007. The relentless campaign against GPs (now clearly orginating from my government)and the money they have received must be unprecedented. Full of distortions (this week 58% pay rises)it approaches being nasty and bullying against some of the hardest working, most dedicated and trusted members of our society. To be honest I probably wont vote in the next election because of the way this government has relentlessly sniped and undermined GPs who earned the money the same government agreed to pay them. The QOF was an agreed set of targets which GPs set out to achieve. Having achieved them, rather than being complimented for their hard work and systems, the profession found themselves targets of a centralised smear campaign. Good management?? Heavens, anyone in business would be sacked immediately for this approach and rightly so. Sales up?? Right we are going to cut your pay and and by the way we still think you are all rubbish. Imagine. Has this approach been run before Mr R Branson? "Oh by the way Mr Branson, if you achieve great outcomes, we will try and reduce your funding and tell the public you are rubbish". Of course, someone of his power and wealth would very politely walk off the pitch with the ball. However no risk of that scenario happening is there? GPs are rightly paid well for the hard work they do. The $64,000 dollar question is whether they should be doing as much work as they do and whether working too hard is bad for them and bad for patients. It is possible that some of the changes the government proposes are aiming for less patient contact and a more reflective and planned approach to care in primary care. If so, then say this and aim for that openly. Don't try and achieve your aims by viscious criticism of successful profession, just doing what you asked them to!
Competing interests: I was a GP partner who received more money from the contract
Competing interests: No competing interests
Re: Get Off Their Backs: Other Changes Needed
Your correspondent reports the ONS (Office of National Statistics)report on productivity in the NHS as stating that GP productivity has fallen since the new GP contract.
The demoralising effect of spin on GP morale has been much commented on elsewhere but this report continues a journalistic tendency not to look behind the headlines of other publications.
The ONS report uses the number of GP consultations divided by the cost of GPs as its measure.Since one aim of the new GP contract was to limit the outrageous hours then worked by GPs and another was to allow an increase in pay to improve recruitment,how could productivity defined in this way do anything but fall?
The good news is that I can immediately improve my "productivity" by halfing the time spent with each patient requiring him or her to come back for a second appointment to deal with issues for which the time proved inadequate.
The ONS does refer very briefly to a need to include consultation length in future analysis but it is disappointing that it currently beleives that quantity of consultations is a measure of productivity.
Primary care desperately needs a morale boost and an attempt to develop meaningful measures of productivity for aspects of care which patients and GPs agree are most important would be a step forward.
Competing interests: None declared
Competing interests: No competing interests