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GPC negotiators expressed anger at the government attempts to claw back investment in general practice by freezing core pay and cutting enhanced services.

Chairman of Scottish GPC Dr Dean Marshall said: ‘How can we continue to deliver the same level of services with decreasing resources and increasing costs? We must make some hard decisions this year to ensure we are able to continue to provide excellent levels of care.’

Scottish practices will lose four directed enhanced services (DESs) worth £12,000, introduced for 2006/7, because the Scottish Executive has decided to only continue with the access DES in 2007/8 (GP, 6 April).

Dr Marshall said GPs must be wary of attempts by NHS boards to commission poorer alternative services.

‘Boards do not like DESs. It stops them from game playing and trying to bully practices,’ Dr Marshall said.

He urged LMCs and practices to ensure local agreements did not expect them to do work that was not properly resourced.

GPC negotiator Dr Peter Holden said GPs had to learn to reject unpaid work.

‘The profession will start to say that we’ll look after patients but if a primary care organisation (PCO) wants this, that or the other then show me the resources. No resources equals no do,’ he said.

GPC chairman Dr Hamish Meldrum said GP leaders were fighting government attempts to renege on elements of the new contract. He expressed concern at the decision to cap pensions, and indications that the government may wish to remove MPIG.

Dr Meldrum said the GPC had reacted to the pension threat by putting in an application for a judicial review.

It would be several weeks before lawyers could confirm that this would proceed although legal opinion was that it would happen, he said.

Dr Marshall added that there was a different pension scheme in Scotland and no decisions had been made on what would happen there.

‘The Scottish health minister has advised me that he has decided to delay making his decision on this issue until the outcome of the legal process in England,’ he said.

Lothian GP Dr Steven Haigh said it was time to ballot the profession to find out their willingness to resign from general practice.

But Glasgow GP John Ip said the time was not right for such an action.

Highland GP Dr Peter Dolan said: ‘Most GPs still believe in NHS general practice and if they want to support that then this would not be the right way.’

GPs rejected a motion to ballot the profession.

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