Not content with grossly misrepresenting the government's position on opening hours, the British Medical Association has now resorted to sabotage to block modernisation of our primary care services.

Richard Vautrey, deputy chairman of the union's GPs committee, has encouraged family doctors to ignore requests from primary care trusts to provide information on practice opening hours and availability of appointments.

The move is intended to undermine attempts by the Department of Health to audit access to services.

This crass, childish behaviour damages both the reputation of GPs and their long-term future as independent contractors.

GPs cannot take state money then refuse to be held to account for the services they provide. The BMA seems to be treating primary care as the personal fiefdom of its members, not a public service.

Dr Vautrey's intervention has provided a powerful argument for replacing traditional GPs with contracted services from major private providers, as no company would embark on a policy of non co-operation with government. So, far from representing the interests of family doctors, he is undermining their viability.

And as a consumer of healthcare I find it offensive that an organisation which purports to represent patients' interests - as the BMA does ad nauseum in media interviews - is working so hard to stop me getting a better service.

There are two groups that need to work out where they stand on all this. The first is the mass of GPs who - even though they may not agree with all the government is doing - must surely wince at the way the BMA is portraying their position.

The second is primary care trusts. As the artillery shells have flown between the government and GP lines, PCTs have been keeping their heads down in the middle.

To a degree this is wise politics; while the principal protagonists indulge in the luxury of conflict, PCTs have to maintain relations and keep services running.

But if PCTs are serious about being in the vanguard of a patient-centred service and delivering on the rhetoric of world class commissioning, they cannot leave all the heavy lifting to the government. Improvement must be led by patient need, not what GPs are willing to provide, which means PCTs having the courage to articulate a vision for local primary care, then winning the arguments.

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