It's an interesting deal, the headlines of ‘back to the old days’ are plainly pants - we are past the Finlay days, kitchen table appendectomies and calling in for a chat are not coming back.
Instead we are being offered the chance to case manage our over-75s in return for less hoop jumping in QOF land. This is undeniably a good thing, Dan Pink in his book Drive - the science of motivation, gives a great example of intrinsic and extrinsic motivation. Extrinsic motivation is when you do something on an: ‘If I do this, I will get that’ basis, intrinsic motivation is doing something because I think it's the right thing to do.
If you ask the kids to do the washing up for a quid they will always expect a quid, and over time the quality falls off until a pay rise occurs. If your kids do the washing up as a one off and you give praise and a non-contingent reward they will keep doing it without expectation, but in hope.
As GPs it's been a failing of ours that we are caricatured as doing anything for money, we all know we do that kind of stuff to earn the bread to allow us to do the right thing. This contract now gives us a great chance to do the right thing, because it's the right thing to do.