There is just one story that is getting bandied around in GP circles this week. It’s the Kent Local Medical Committee (LMC) motion,° debated at the national meeting, that home visits should be removed from core contract work.

Now, I’ve little sympathy for the heart-tugging nostalgic view of general practice that is peddled by dewy-eyed traditionalists. But, really, what on earth were they thinking? It takes about 30 seconds to spot the flaws in this suggestion. It fragments care, disrupts continuity, and it wages its effect on the most vulnerable people in society. It throws the housebound, disabled, and terminally ill under the bus. Did we learn nothing from the 2004 contract when we gave up out of hours care? The splintering of primary care into separate pockets damages services and will always have a disproportionate impact on the most needy.

I’m all for radical thinking and I appreciate that GPs are hard-pressed but this is so desperate I wonder if it is incredibly Machiavellian. Bear with me, I’m trying to be charitable. Maybe it’s actually a clever way of highlighting how parlous the situation is, that GPs would even countenance such a policy. It might yet have that effect, and things are undeniably hard, but this doesn’t seem conspiratorial. It has cock-up written all over it.