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Contract underway but GPs gloomy about the future of health service

Published on 06/04/04 at 11:38am

The long-awaited new General Medical Services contract has arrived, with the majority of general practices in the UK now working to the quality-based, target-driven system.

At the heart of the contract are the twin aims of making general practice a more sustainable and attractive job for the over-worked, understaffed GP population while at the same time improving access and quality standards for patients.

Many GPs are now anticipated to opt-out of providing some 'enhanced services' such as out of hours care, but a Patient Services Guarantee has been enshrined in the new contract to ensure the local population will still have access to the necessary range of services.

Meanwhile, funding for primary care will increase by 33% over three years to improve pay and conditions for GPs and their practice staff, and also, crucially, to re-design services around patient needs.

NHS Alliance chairman Dr Michael Dixon said although agreeing the new contract had been  'a rough ride in parts' it would bring about real benefits for patients.

"For GPs, the contract represents not so much a revolution as a turning point a recognition that the NHS relies more than anything on the quality of general practice. It will restore a new confidence and value to the GP role that will attract young doctors to take up its challenges and rewards."

Coinciding with the launch of the new contract, a straw poll of 78 doctors by the BMA News poll uncovered some deeply pessimistic views about the future of the NHS as a whole.

Sixty percent said they did not believe there would be a recognisable NHS in 50 years, while about the same amount said they weren't in favour of the 'increasing diversity of provision' through reforms such as foundation hospitals and treatment centres.

Neither were the respondents convinced that changes to the medical education of doctors would produce better professionals in the future, with 49% saying 'no' compared to 29% saying 'yes' with a further 22% 'unsure'.

Despite reservations about change, GPs are set to become the linchpins in the increasingly important principle of patient choice. Results from pilot studies in which GPs offered patients an option of four to five hospitals in which to have surgery found patients valued having the choice, even if they did not exercise it. Patient choice will become mandatory by December 2005, when the government hope further research and improved IT structure will make it a viable system.

The research was published alongside another survey conducted by MORI on increasing choice throughout the NHS.

The poll found 76% of patients wanted more involvement in decisions about their condition and treatment - rated as the top priority by patients, above being treated with respect and dignity and being listened to, scoring 59% and 47% respectively.

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