I'm not massively keen on working out-of-hours. I work hard from 8.30 in the morning to 6.30 at night. I've just finished a long surgery. I'm tired - that's the reality of general practice.

Just a few years ago we all opted out of out-of-hours work because it was encouraged at the time. Now the government has realised that the best way of providing out-of-hours care is through GPs, but we have to be adequately paid to do it.

I'm sick to death of more reforms. What's the point of setting up new arrangements when we'll only have to change them again in a few months? It's like being on shifting sand.

Patricia Hewitt's whole attitude to primary care is negative and undermining. She talks about GPs giving ridiculous appointment times. But we have been really struggling to provide a good appointments system for our patients.

It's very important to listen to what patients want. But it is just as important to listen to what doctors, nurses and health visitors feel they are able to provide. We are not listened to and the implication is that we are not professional enough, which is very undermining.

There's a basic shortage of GPs, unless you make doctors feel valued, you are not going to retain them. That's the problem.

In theory it's lovely to think that patients will be able to go their GPs whenever they want - to have all their diagnostics done, as well as minor surgery and post-operative care. But who is going to pay for it?

It all feels like it is being taken out of GPs' hands in order to provide a private service that the government will have more control over.

All the talk about patient choice really irritates me. We had a wonderful health visitor service in our surgery that was very popular. But there weren't quite enough health visitors to go round.

Without any consultation, the health visitors have all been centralised. So now patients have to go to some crappy clinic down the road, where they have to wait for two or three hours to be seen. Imagine being a new mum with a toddler in tow, possibly with postnatal depression. You just wouldn't face it. That has nothing to do with patient choice.

Health MoTs are a good idea, if you have the staff to do them. But we are already snowed under with the work. And it is going to be the professional people that come to make sure their cholesterol is OK, not the vulnerable with the highest needs.

The health service doesn't feel safe in the government's hands; doctors need to be consulted more often.

· Interview by Matt Weaver