One in six GPs has considered throwing in the towel as morale in the sector continues to decline, a survey of doctors by the British Medical Association has revealed.

The key root of doctors’ current unease seems to center on the government’s increasing reliance on privatisation as the white knight of service improvement, coupled with widespread feeling that the core values of general practice are being undermined to the detriment of patient care, the BMA says.

There is significant concern that too much emphasis is being placed on cost-cutting and quantity of care rather than quality and, according to the survey, which questioned more than 11,000 GPs, more than half of respondents claimed that morale has taken a dive over the last five years.

As a further illustration of doctors’ seemingly bleak outlook on healthcare, 63% said they felt National Health Service reforms over the past ten years have actually created a more difficult environment in which to practice “good medicine”, and only half would recommend a career in general practice to an undergraduate.

Another sticking point between the government and GPs is the issue of out-of-ours care. In 2004, a radical change was introduced into the GP contract that allowed doctors to opt out of out-of-hours care for a pay cut of just 6%, leaving primary care trusts with the responsibility of dealing with the approximate nine million who require such care in England every year.

Out-of-hours care back to GPs?

However, it looks as if responsibility could be handed back to GPs, with both the Conservative and Labour parties voicing their support for such a move. Just this month Tory leader David Cameron has unveiled plans to renegotiate the GP contract so that local doctors regain responsibility for out-of-hours services from primary care trusts.

And hot on the heels of this announcement came the interim report of Health Minister Sir Ara Darzi’s review of the National Health Service, of which a central aim is to extend the opening ours of GP surgeries to provide better access to primary care.

But the idea has been vetoed by the BMA, with Dr Laurence Buckman, chairman of its GP Committee, warning earlier this month that it is “not safe to ask exhausted GPs to work nights and weekends as well as in the daytime”. And results of the survey indicate that doctors also remain unconvinced by such a move; while 53% of GP partners would consider extending opening hours if the resources were available, nearly three quarters do not believe it is a good way to spend scarce NHS resources.

Commenting on the survey’s findings, Buckman concluded: “GPs are worried about the future of general practice in this country, they have concerns about the negative impact current policies could ultimately have on patient care and they feel they are being attacked for achieving and surpassing government targets. That is why the morale of GPs is low…We need to see that the changes that are currently being mooted are for sound reasons and that they will really be of benefit to patients.”

And he warned: “If we are not very careful, we will have a private health service without continuity, provided by large businesses working from remote premises. We remain to be convinced that is what our patients want.”