What is the fucking point? (part three)

The Government are a bunch of cunts.

No, that is too restrained. They are a collection of duplicitous cunts; reneging cunts; lying cunts; and utter fucking cunt-slime of the most dishonest kind imaginable.

And they are cunts who hate doctors. At every stage of a doctors career, New Labour has introduced barriers and obstacles to fuck them over.

Fresh A-level students now have to sit a 'clinical aptitude test' which was forcibly implemented to select candidates, despite the fact it never worked.

The syllabus of a medical degree has lost the core subjects of anatomy, physiology and pathology, to be replaced by the touchy-feely bollocks approaches of 'communication', so that doctors can now empathically tell relatives that their loved-ones have died due to the fact that they fucked up the surgery / internal medicine / disease management.

MTAS came along and bent a generation of doctors over a barrel, and fucked their present and future careers firmly up the arse.

And then came along the GP and Consultant contracts.

The government thought that doctors spend half their working hours on the golf-course, and wanted to get more work out of them, so entered into negotiations about performance related contracts.

Doctors realised that most of them worked 100+ hours per week, and despite the views of the conservative former health secretary, Kenneth Clarke, most of them didn't know one end of a golf club from another. And so the new contracts were born.

GPs received a pay rise, albeit it performance related. They were given the option of opting out of Out-Of-Hours (OOH), albeit for a massive pay cut. And GPs were allowed to choose whether they would do work not specified in their contract; roles like removing sutures and dressings applied by the local hospital could either be returned to the place that applied them, or charged for.

Things started to go wrong for the government when almost every GP decided to take a massive pay cut (£6,000) rather than take part in OOH. GPs found that OOH was a massively abused service. Whereas few GPs would object to visiting a patient with an attack of angina, OOH was mainly used by people wanting antibiotics for viral illnesses, or a letter for the council or for court. And so, like a shitty stain, GPs washed their hands of it.

Then came the Quality Outcomes Framework (QoF) results. Most GPs scored very highly, reaching targets for the management of chronic diseases, such as cardiovascular and respiratory illnesses. QoF was all about performance related pay, and high scoring GPs were paid accordingly.

Of course, the government ended up fucking up the contract. In thinking that GPs spent all their time on the golf course, they hadn't realised that well educated, highly motivated professionals would reach most of the targets.

And so, the government mission of fucking over GPs began.

First came the attack on pensions. Rather than pay the employer contribution part of a GPs pension, the government paid it into the GPs wages. And then announced it as a massive pay rise. And then taxed it.

Then came the attack on GP wages. Rather than take the approach of telling the public that GPs spent all their time playing golf, New Labour delighted itself by telling the public that all GPs were paid £250,000 per annum, and wouldn't open nights. Well, a typical salaried GP earns £60,000 per year, and a GP partner is given just over £100,000 per year to run his small business, which includes rent, staff wages, professional costs and pension, before he can afford to pay his own wages. And by their own figures, 84% of the UK population were happy with GP opening hours and current OOH services.

And then came the two highly generous pay rises. Yes, rather than the below inflation pay rises that most public sector workers got, GPs were awared 0% and 0% over the last two years.

And it continues. The latest act of the government is to openly flout the terms of the GP contract. Rather than renegotiate the contract, they have decided to ignore it.

The fuckwits in government have decided the most important health policy to force through is changes to GP opening hours, without paying for it.

If is bad enough that the spineless cowards in the BMA were prepared to offer two extra unpaid hours per week for every 6000 patients on a GP list.

But the government want more. Much more. They want three hours per 6000 patients, in longer blocks, and they want to re-allocate some of the QOF points to make them based on OOH, too.

It may not sound like much. But this will cost the average GP practice over £36,000 per year in terms of both unpaid work, and employing support staff.

Well, New Labour - Merry fucking Christmas, you fucking Scrooges. In order to get yourselves re-elected, you are destroying General Practice. Utterly and Completely. You seem to think that GPs should alter their opening times to suit the few who demand OOH care, rather than the majority who need it, the elderly, the young, and the disabled.

The jewel in the crown of the NHS was the continuity of care that primary care could provide. New Labour wants to replace this jewel with a turd; this turd being an amalgamation of walk-in centres, Polyclinics, NHS direct, community noctors, and all other forms of faeces devised to turn GPs from the gatekeeper of primary care into a politically expedient wage-slave.

It is time for a fight. Not the kind of leaflet campaign that the fucktards running the BMA would probably recommend. It is time for GPs to take the offensive.

There are many ways to do this. There is the "Don't use Choose and Book / NHS-IT" approach, refusing to use the poorly-functional NHS computer systems, which have cost more than the 2012 Olympics. There is the "Refer everything" approach, which could fill outpatient and A+E departments in days, as GPs refer every case that they are not 100% certain of, to ensure patients get as many possible opinions as possible. And there are other approaches, including the above, which would not be considered industrial action, which would thoroughly fuck-up the government's 18-week targets.

And there is the "let's do what the dentists did and fuck off" approach, for GPs who are not anchored by PFI/PCT contracts to pay the mortgage or rent on their surgeries.

There is of course, the all-out 'have a strike' approach, which will fail due to a combination of New Labour spinmongering and BMA cowardice, and the fact that most GPs have patient interests at heart.

However, New Labour will not get the whimpering capitulation that they are after. If they want a fight, they will get one, and it is their nose that shall be bloodied.

And they can get it seen to in one of their fucking Polyclinics.