The current problem over GP opening hours arises from the 2004 contract that was freely agreed between ministers and GPs. The Government now wants to alter that contract significantly, to GPs disadvantage, and without negotiation.
In short, there is no carrot on offer to GPs at present, just a big stick wielded by an angry Govern- ment. The feeling GPs have is that the Government is negotiating with them in bad faith and by raw exercise of power. Alan Johnson's letter is an iron fist, concealed in a velvet glove.
I accept that taxpayers have had their money poured into the NHS in recent years and have little to show for it. The money has been squandered, but not on salaries. It has gone on overpriced private finance initiative projects (yes, Bob Heys is right) extra management, management consultancy, needless restructurings and £20 billion on the barely functional computer system known as Connecting for Health.
Far too little of the extra Government investment has gone on anything useful to front-line services. Hence the Government's achievement of a huge investment and few happy returns.
As regards GP hours, I accept that current opening hours, 8am to 6.30pm each weekday, are not ideal and there are many who find it hard to get convenient appointments. The problem is recognised both by the British Medical Association (BMA) and the Government.
As a doctor, and for the sake of patient care, I hope the Govern-ment and BMA will get negotiating again, confine the problem to getting a deal about opening hours and leave the contract otherwise unchanged.
Using the mechanism of locally enhanced services, agreed to meet local needs between local primary care trusts and local, willing GPs, this could be achieved with no need for any contract changes or arguments.
If the Government continues to try to bully GPs and impose unfair contract changes on us then we may go the way of the dentists. That is not an outcome doctors, patients or voters really want.
Finally, please, can I assure patients that every doctor I know wants to do the best they can for each patient they treat. That is our basic core commitment to patients: to use knowledge with compassion to help our patients in relationship-based practice.
The current row threatens to hinder our ability to achieve this.
(Dr) Peter Davies