Dr Disgusted - March 2006 Yorkshire Post

Dear Sir

Patricia Hewitt says it is doctors’ fault that the NHS is in financial trouble.
She says that there is “clinical resistance” to change.

Doctors pay has apparently cost more than the Government expected!
The main reason for the NHS crisis is an inept meddling Government.
Less than two years ago GPs negotiated a new contract. Two key elements were a change in our working hours and performance related pay.

The performance related pay consisted of clinical and administrative targets awarded on a points basis. The maximum achievable was 1050 points. The Government estimated GPs would achieve about 750 points on average. The average achieved was more than 900 and some achieved the maximum. This was due to hard work by doctors and their staff. This benefited patients and consequently cost the Government more, hardly GPs fault!

In regard to working hours, our commitment was reduced from 24 hours, 365 day cover to 8-6.30 Monday to Friday. We could then opt out of the remaining hours for a payment of about £7000 per annum. Most of us did this. The Government had been paying GPs very little previously for excellent out of hours cover. Now faced with market forces the cost to obtain GP cover out of hours has become realistic costing the Government more, hardly GPs fault!

In order to reach Government targets, many hospital trusts paid consultants large sums to clear waiting lists in their own time. Now with a crisis looming those same consultants have been instructed to stop seeing patients in order to balance the books on March 31. This has cost the Government more, hardly Consultants fault!.

As for clinical resistance to change, having spent many years sitting in NHS management meetings I can tell you that the resistance is largely due to the inability of NHS managers to make decisions. This is not due to the lack of able managers but to the culture of fear, poor guidance and continuous changing of direction created by central Government.