The case of the independent DDRB that wasn't

Dr Rant has friends in places both high and low, but few are more strategically placed than our friend on the GP Committee of the BMA, the body that is a responsible for directly negotiating with the government when it comes to GP contract issues.

It will come as no surprise to you that the government employs shady practices and exerts undue influence on supposedly independent public bodies, but it gives us great pleasure to give you some specific details.

For the past two years, GPs have received a 0% annual increase in their total (gross) income in a shameless claw-back after the freely and fairly negotiated new GP contract was introduced in 2004. Out of this generous 0%, GPs are expected to pay their staff annual increases and meet the rising costs of running a business and heating a building etc.

The annual pay rise for doctors and dentists in the NHS is decided by a body called the Doctors and Dentists Review Body (DDRB). This body is supposed to consider evidence from the government and the BMA before coming to an independent decision which should be then accepted by the government.

It has become abundantly clear that the Government thinks that they will win the next election if they have force GPs to offer routine appointments at weekends and in the evenings, despite the fact that 84% of people are happy with their surgery's opening hours. The government is also determined that this increased access with come at no extra cost to the DoH - i.e. for free.

Here's what actually happened:

Government Fuckwit (DoH): Right you Bourgeois pigs - we think we'll win the next election if we can get you to open at the weekends and evenings, so that the worried well don't have to miss the Jeremy Kyle show. Trouble is, we not going to a pay a penny for it to happen. We're going to reduce the amount you get paid to do things that you do already, and you can only have it back if you open extra hours. Pass the caviar Quentin.

GP Committee (GPC): What? So you want to pay us less for doing things that have been proven to make people with chronic diseases live longer, less miserable lives, just so a few Daily Mail reading reactionary shit for brains can whinge at us in the evening. Isn't it their employer's duty to let them have time off to see during normal hours anyway?

DoH: Well, we are prepared to let you shut during normal hours - let's say 2 hours for every one hour extra you do.

GPC: Wait a minute, you want us to reduce the quality of care we provide to people who really need it and make it harder for acutely unwell people to see a doctor whilst at the same time giving the Daily Mail a opportunity to whinge about us earning the same money for fewer hours? Anyway, have you actually ever been to a General Practice? There's no way we can shut during the day because we're already working flat out and you will create additional demand (rather than redistribute it) by opening later. You know that GPs will end up staying open anyway without getting paid.

DoH: (knowing smile)

GPC: This is a shit deal, that will actually be bad for patients and create demand that isn't actually there now. If you want us to open extra hours, we're happy to do it, but we need to be paid fairly for this. It will still cost less per consultation than your useless NHS Direct and Walk-in centres where there isn't a doctor in sight.
To be honest, we're inclined to tell you to go fuck yourselves.

DoH: Alright then, how about we'll look at some of your priorities like actually having buildings that are fit to practice medicine in. If you play nicely, we won't interfere with the DDRB recommendation for this year. How does 0% for the third year on the trot sound?

GPC: What the fuck? The DDRB is an independent body. You can't do that, and it would be an abuse of political power for party political means.

DoH: (smirk)

Don't you just love open and accountable parliamentary democracy?