<< The extent to which the prior position was agreed varies every time the
tale is told .... If it helps you to think of A as an imposition go ahead.>>

In the beginning there was no agreed solution. Then "A" was proposed but not
agreed. To have insisted that "A" would be implemented regardless would have
been an imposition. So yes, to threaten a much less acceptable "B" in order
to make us "agree" to "A" makes both of them impositions. It is not a state
of mind Fay. This sounds more like the sort of treatment handed out to
miscreant pupils in a public school that the adult communication which might
reasonably be expected between government negotiators and an established
professional body. A like for like response might have gone along the lines
of "If you impose unilateral terms, all work on the multibillion pound NCRS
project which impinges on primary care will be stopped until we can
re-establish a process of mutual negotiation, and if we are unable to
acheive this together then we would consider independant arbitration". We
play ball in so many unfunded areas that the scenario where GPs leave the
NHS en masse (which our negotiators later, unwisely flirted with in public)
would be a highly improbable last resort.

My dilemma is this:

"A" appears at first sight to be the less damaging short term scenario. But
if we vote for this we are giving HMG the message that the fundamental
principle of pay being determined through negotiation is GONE. We would be
setting a precedent which condones the un-negotiated unilateral imposition
of terms (extra work for less money). If I were them and saw that a majority
of GPs were prepared to accept this (because I had threatened them with
worse) I would quite rightly think that I had licence never again to return
to the negotiating table. My next question is this. What is there to stop
them doing exactly the same thing again, imposing whatever terms they fancy
at whatever time in the future they please? Absolutely nothing.

So to my mind rejecting "A" is unquestionably the right thing to do.
However, if the draconian threat of "B" was imposed I would feel obliged to
use every measure at my disposal to withhold co-operation in other areas
until it was perceived mutually beneficial to restart negotiations.
Fortunately, at this moment in time, we all have the means to do this very
effectively, and without significant damage to the medical care on offer to
our patients - which may not always be the case.

So why are our leaders not presenting the profession with an option which
they were toying with less than 1 month ago? Maybe as Andy suggests they
think they already know the answer (although the polls in the rags don't
seem to support their concusions). More likely they believe that an outward
show of conservatism might secure their future prospects, or they have been
heavily leant on by the considerable political pressure in that environment.
Either way, I have not yet heard a good argument to justify their actions
and I resent not knowing and dislike these clandestine tactics. A good
number of hard working jobbing GPs beleive that it is entirely justifiable
in these circumstances to consider confrontation and that this should be
presented to us as an option to consider. If the majority decide to vote for
"A" then so be it. But to hear that this is "not an option" from within my
own profession is nauseating propaganda which is simply not true. Our
representatives should not assume that they have prior knowledge of what is
best for us. They should ask us if we accept "A" and if not, in response to
the imposition of "B" if we then support measured confrontation designed to
re-establish negotiations. Many, quite possibly a majority would say yes.
Not to do so is weak, unwise and likely to seriously compromise the future
of our profession.

Laurie




-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Fay Wilson
Sent: 13 February 2008 19:58
To: [log in to unmask]
Subject: Re: extended hours: shift work not allowed?

I have only ever called it option A and B as I considered the use of the
term "Imposition" to describe A was dishonest. A is the offer, B is the
threat. Despite having heard it dozens if not hundreds of times I am still
unable to understand why the corporate view of GPC has shifted from December
to February.

Possible explanations for change in direction:
The main issue causing the panic seems to be the permanent extraction of
136 QOF points under B since there is nothing else that has materially
changed. The odd thing is that this was anticipated in December.

There is a tale going around that under B the stolen QOF points will be
redirected to corporate APMS providers in order to undermine general
practice so we need to Vote A to keep all 1000 QoF points in the national
contract not in the hands of the wicked PCTs and their more wicked APMS
bogey men.

Finally, there is a theory that the government really wants us to vote B so
they can privatise general practice and blame us, so the smart people will
see their bluff and vote A. I don't buy it myself. If they are that smart
they could be double bluffing us to make us think they want us to vote no
when they really want us to vote yes... etc

Fay


Andy Lee wrote:
> Fascinating how the language used has changed so quickly. Laurence
Buckman's 'letter' emailed by the BMA to those on its mailing list today
refers to Option A and Option B. Earlier this week at my LMC's roadshow, the
terminology used (more accurately) was Imposition A and Imposition B since
neither is particularly an option except in muggers' terms i.e. "Give me
your money or I'll knife you". Laurence wants to help us so he particularly
emphasises that he doesn't want us to abstain as he clearly wants us to
choose between the 'options' as he chooses to call them now and to help
further he has even defined the issue for us as a choice of which option is
"less worse for your practice, your patients, and the future of general
practice". This might have the convenient effect, if followed, of GPs
reaching the same conclusion as the GPC, since most would prefer to hand
over the money than suffer the knife, but there's a clear overtone to this
that there's no
>  chance of anyone being around to offer any assistance in your ordeal with
the mugger so don't bother considering any outcome other than handing over
your money or being stabbed. Some of us might have thought we were paying
contributions to a form of 'bodyguard service' that might try to protect us
from the muggers but it appears the limit of that service is to simply
advise us to consider whether it is more detrimental to our wellbeing to
hand over the dosh or be stabbed. Perhaps many will tempted to consider how
worthwhile it is to continue contributing for receipt of such advice? My
view, like Adrian's, is that we have a variety of ways we can choose to
devote our time and receive consequent financial reward, not only the two
impositions brought forward by government and I would have expected a
'bodyguard' worth paying for to have shown more initiative and resilience in
a similar fashion. There has been an almighty and sudden shift in the
language and
>  attitude coming from the GPC/BMA. A short time ago it was almost daily
campaign emails, posters and handouts, suddenly its capitulation. Just who's
future do they fear to be at stake most here, GPs or the negotiators?
>
> ----- Original Message ----
> From: Fay Wilson <[log in to unmask]>
> To: [log in to unmask]
> Sent: Tuesday, 12 February, 2008 9:47:38 PM
> Subject: Re: extended hours: shift work not allowed?
>
> Our negotiators have formed the view that Option A is less damaging than
> Option B.They have formulated a set of questions that compels you to
> vote for either Option A or Option B. Whether this is playing into the
> hands of the government or a piece of devilishly cunning double bluff
> remains to be seen.
> Fay
>
>
>
>
>