Letters Changes to the GP contract

Problems with the GP contract date back to 2004

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e7816 (Published 03 December 2012) Cite this as: BMJ 2012;345:e7816
  1. Hendrik J Beerstecher, general practitioner1
  1. 1Canterbury Road Surgery, Sittingbourne ME10 4JA, UK
  1. hendrick.beerstecher{at}nhs.net

The time for action on the GP contract was in 2004.1 In exchange for quick and easy cash from the Quality and Outcomes Framework (QOF), the core General Medical Services (GMS) contract was left vulnerable to unilateral imposed change, did not specify core duties, and did not contain inflation proofing.

Clinical commissioning groups have brought no extra work or legal requirements, there is no contractual obligation (yet) to do any of this work, and those who volunteer are either well remunerated or must be enjoying the avalanche of paperwork. The BMA could have simply advised doctors not to engage in deckchair rearranging.

The failure to ensure that unfunded changes to the QOF could not be imposed unilaterally leads back to the decisions made in 2004; the structural soundness of the contract was neglected in the scramble for John Reid’s fiver.

It was predicted: “We have got the pigs in the pen, now watch us change the shape of the pen.”2

The editorial ignores some of the good sides of the proposals,1 like the long overdue equalisation of funding for core services. This should extend not only to personal medical services, but also to alternative provider medical services and primary care trust medical services, which have enjoyed disproportionate amounts of funding.3 Same pay for the same work will be a welcome relief for GMS practices.


Cite this as: BMJ 2012;345:e7816


  • Competing interests: HJB is a GP in the only practice in Kent not affiliated with a clinical commissioning group (orphan practice).


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