The new contract for 2024/5 has just been announced for the NHS and General Practice. The view on different platforms is… that it will make only a tiny difference to practices. I can't agree with that, though. In my view, it is going to make a huge difference to practices and patients, and we cannot ignore it.

Let me explain. On the back of inflation last year of about 11%, the final pay award was under 6% (which when netted down was even less) as it did not cover the whole GMS income.

We were then mandated to give all clinical staff the full 6% increase, but when it came to other staff, a lot of practices could not afford the 6% as they were heavily reliant on salaried GPS, and so the income increase was nowhere near the 6% in total.

In our case, the non-clinical staff only got 3% and it looks as though this year again there is going to be another clinical / non-clinical split in increases.

This is unacceptable, and in some cases there may well be staff having to be let go, to keep practices solvent.

That will alter the capacity for patients, adding further pressure onto an already overburdened Primary Care.

Is this a deliberate ploy by the government, so the public (not being privy to the workings of primary care) will think that we are being greedy?

I cannot help feeling that as we are easy targets, we are expected to roll over and accept this derisory increase in GMS. The comments that a review board is looking at the pay and further increases may be offered down the road is not enough for those practices already on the brink.

It is amazing how quickly the government produced the £37m for MPs’ security and other pockets of money announced last week. 

With Primary Care in decline, will the government provide GP practices with more security, when patients rebel against a decrease in services due to underfunding?

What can we do to make our voice heard and put pressure on for a just settlement?  Whilst I would never advocate strike action, due to the consequences on vulnerable patients, I would support targeted action – say, fewer doctors on duty, or for emergencies only.

Unlike the government, we cannot borrow to keep going. We have to, and will, work within our means and if difficult decisions need to be made, then so be it.

Times are looking gloomy.