Back to Earth, back to reality

If your contract at work meant you had to work nights and weekends throughout your working life, and then some government came along and said: you don't have to do that any more, and here's more money for your (less) trouble, wouldn't you grab it with both hands?

That's exactly what happened to GPs in 2004. And of course, we grabbed it in our greedy little mitts like anyone else would. But then the opposition began. At a personal level, even some of my own friends expressed their disquiet over the highly favourable deal the BMA had secured with the labour government of the day. With the ending of our responsibility for covering our patients "out of hours", the government instead put in place special centres designed to replace us. That's when the problems really started. People were poorly informed about the changes, and started using A and E departments as their OOH cover, placing intolerable strains on that service. Then an influx of immigrants arrived who naturally used A and E all the time because that's what they did in their own countries.

Now, and some would say, not a moment too soon, the coalition has introduced plans to return some of these OOH responsibilities to the people who are best placed to carry them out. And I have to say, much as it goes against the grain to agree with a Tory plan, it's probably a good thing. Problem is, it's going to take years to re-educate the public in how the new system will work, so expect more chaos and lengthy waits at A and E before that happens. This winter could be the worst one yet, especially if we get a nasty flu epidemic, which is overdue on statistical terms at least.

GPs used to be some of the most respected people in our community. I fancy this has changed now many see us a greedy, money-grabbing and workshy. Perhaps now we can rebuild our image as caring professionals who demand a solid working wage but are not afraid to do a bit of extra work to justify it. And in terms of how we are viewed around the world, we've got to make the NHS work, if we are to be a model of excellence and the gold standard for health care, and not the object of contempt and derision.