ࡱ> y{vwx @ kbjbjqq .~c lllllllHHH8d4UJ$^]]]ԇևևևևևև$RlD]]DDllD^llԇDԇroll SF)H^`wr<%0Uwlllll]y]]][$^$[$^Communications Report Polyclinics and the issues surrounding the proposed Darzi health centres attracted most media coverage recently with 63 different mentions in the newspapers, radio and TV. Every opportunity was taken to put forward the GPCs messages including concern about the spread of commercial private companies into general practice and the potential effect on services for patients. The Scottish LMC conference also attracted plenty of media coverage. See below for details of all media mentions we have had notice of. Press Releases April May 2008 17/4/08 GP leader opposes headlong rush to polyclinics 17/4/08 An unworkable idea, says GP leader 8/5/08 BMA launches its national Support your Surgery campaign GP National Coverage April 2008 Total 81 made up of Print 69 Broadcast 12 Top Stories PrintBroadcastPolyclinics174NHS Admin12Out of Hours82Screening63Pharmacists8Extended hours32Pay4Charging31NHS Funding1Patient safety1Cancer1Workforce1IT1Image1Private1TOTAL6912 BMA Spokespeople SpokespeopleTVRadioPrintLaurence Buckman1415Richard Vautrey222Chaand Nagpaul11Kailash Chand1David Bailey1Andrew Green1Nigel Watson1TOTAL4721 Print 1/4 Times Jackpot for some GP practices P4 2/4 Daily Telegraph High street chemists to take over range of GP services P1&2 Daily Express Health MoT same old cure P9 Laurence Buckman quote Daily Mail Health MoT for the over 40s will save 2000 lives a year P19 Laurence Buckman quote Daily Telegraph Health MoTs will save 2000 lives a year P4 Laurence Buckman quote Guardian NHS to provide health MoTs for all aged between 40 and 70 P11 Laurence Buckman quote 3/4 Sun We gave five over 40s a health checkthe most nervous was the healthiest P42,43 Laurence Buckman quote Independent Plea for GPs to prevent not cure P34 BBC Online Chemists to offer GP services Financial Times Challenge to GP practices P4 4/4 Guardian Wider role planned for high street chemists P10 Laurence Buckman quote Daily Express Chemists to take on GP work P5 Daily Telegraph Late opening surgeries P27 5/4 Daily Telegraph Consultants should see patients at GP surgeries P6 Times Winding up the doc P8 6/4 Sunday Mirror GPs shun 360m IT P16 7/4 BBC Online Is this the end of the old style GP? 9/4 Guardian NHS GPs at new Virgin health centres will get 10% of profits P6 Richard Vautrey quote Guardian Dispensing with routine P7 10/4 Daily Mail Out of hours chaos puts patients at risk P19 Metro Out of hours NHS care is a headache P29 Daily Telegraph Health muddle puts lives in danger P1 BBC Online Return out of hours care to GPs Richard Vautrey quote 11/4 Financial Times GPs set to lose income guarantee P5 Laurence Buckman quote Evening Standard Surgeries will close if GP pay deal is axed P4 Laurence Buckman quote 12/4 Times Grounds for complaint P8 Daily Telegraph GP reforms could force one in 10 surgeries to close P10 Laurence Buckman quote 13/4 Observer GPs warned over failure to diagnose cancers P1&3 Sunday Times Patients told: only one illness at a time please P4 Observer Do the hokey cokey Gordon and youll get shaken all about P27 The Mail on Sunday Anger at 1113 a head subsidy for GP practice at Palace P43 14/4 Daily Telegraph Britains vanishing way of life revealed P1&6 15/4 Times Doctors plan PR offensive P4 Kailash Chand quote Daily Mail Ask the doctorP48 16/4 Daily Telegraph Out of hours doctors told to reduce home visits to save cash P2 Daily Mail Out of hours firms use nurses not doctors to save money P32 Laurence Buckman quote 17/4 BBC Online Health managers back polyclinics Laurence Buckman quote Metro Doctors oppose rush in super clinics P4 Laurence Buckman quote Daily Telegraph English patients go to Wales for free prescriptions P10 David Bailey quote Evening Standard Patients are left with no GP as cuts shut clinic P24 Daily Telegraph Protection for GPs P25 Times A second opinion P6 Guardian Outcry over exclusive GP surgery at Palace P5 Financial Times GPs could face fee if patients use A&E P4 Laurence Buckman quote Guardian Patients who go to A&E instead of local surgery could cost GPs 1bn P9 Laurence Buckman quote 18/4 Daily Telegraph The financial implications of out of hours GP care P25 Daily Telegraph Doctors face 900m bill in A&E shake up P12 20/4 Independent on Sunday From Dr Finlay to megastores P51 Independent on Sunday Struck off P1,8&9 Laurence Buckman quote News of the World 1700 GP surgeries to be shut P38 Sunday Times Patient safety P18 Andrew Green quote 21/4 Times Cameron goes to the doctors for a prescription to kill polyclinics P26 Daily Express Labour killing of GPs says Cameron P2 Daily Mail 1700 GP clinics facing closure P34 Sun 1 in 5 GPs to close P2 Daily Telegraph Tories will fight to save family doctors P1 22/4 Daily Telegraph Meddling with GPs P23 Guardian Polyclinics will cause upheaval, says Cameron P13 Financial Times Cameron accuses Labour of undermining GPs P4 Daily Telegraph Polyclinics will hit most vulnerable P12 23/4 Guardian A wider role for pharmacists needs to be defined P2 Guardian Over the counter culture P1&2 Chaand Nagpaul quote 24/4 Daily Telegraph GPs to get no say in building of super surgeries P14 27/4 Independent on Sunday Letters, emails and texts P56 Independent on Sunday Letters, emails and texts P56 30/4 Daily Telegraph Undervalued doctors P19 Guardian Polyclinics and privatisation P33 Mirror GP U-turn by Tories P15 Broadcast 23/4 You & Yours 17/4 Wake up with Wogan Laurence Buckman interview BBC R4 PM programme Laurence Buckman interview BBC R4 Today Laurence Buckman interview BBC News 24 Richard Vautrey interview BBC Breakfast Richard Vautrey interview 16/4 BBC R5 Live Richard Vautrey interview 10/4 Sky News Radio Richard Vautrey interview 1/4 BBC Breakfast Nigel Watson interview BBC Radio5 Live Chaand Nagpaul interview BBC Breakfast Laurence Buckman interview BBC R4 Today Laurence Buckman interview Regional GP coverage April 2008 Total 151 made up of Print 78 Broadcast 73 Top Stories Polyclinics42Screening34Workforce12Extended hours12Patient access10Industrial action10NHS Admin8Choice5Private3OOHs3Cancer3 BMA Spokespeople SpokesmanTVRPLaurence Buckman1214Dean Marshall17Richard Vautrey61Kailash Chand6David Bailey4Adrian Midgley4Grant Ingrams3Tom McKinstry2Fay Wilson2Andrew Buist1Prit Buttar1John Canning1Jonathan Fielden1Paul Hobday1 Print 1/4 Hartlepool Mail "Screening bid to save 2000 lives" P10 Wolverhampton Expresss & Star "tests for all to help stop killer diseases" P6 Peterborugh Telegraph "Health test plan for over 40s" P4 Newcastle Chronicle "Screening for killer diseases" P4 Norwich Evening News "Screening for killer diseases" P6 Leicester Mercury "Health checks for all will save lives" P9 Manchester Evening News (3rd ed) "Everyone over 40 to be offered checks for killer diseases" P6 Barrow Evening Mail "Health test screening for the over 40s" P4 Wigan Evening Post "Health MOT offered to over 40s" p6 Huddersfield Daily Examiner "Screening will save 2000 lives" P8 Jersey Post "Over 40s offered screening for killer diseases" P15 Lancashire evening Post "health MOT offered to the over 40s" P6 Chester leader "NHS health screening plan for the over 40's" P10 Shields gazette "Over 40s set to get check-ups" P8 Oldham Chronicle "Fears over health MOTs on NHS" P4 Richard Vautrey quote Cumbria News & Star "Killer illnesses screening bid" P6 2/4 Western daily Press "The middle age MOT" P23 Laurence Buckman quote Oldham Chronicle "Health MOTs a gimmick" P21 Kailash Chand quote Newcastle Journal "health checks for millions of adults" P16 Laurence Buckman quote London Metro "Chemists to offer health check-ups" P2 Birmingham Post "Stroke tests will be rolled out to community centres" P4 Bromley news Shopper "Have a say on health issues" P19 Bournemouth Echo "Checks and balances" P23 Darlington Northern Echo "NHS health checks to save 2000 lives a year" P7 Laurence Buckman quote Durham Northern Echo "NHS health checks to save 2000 lives a year" P7 Laurence Buckman quote Yorkshire Post "Life-saving health checks to cost 250m every year" p6 Laurence Buckman quote Yorkshire Post "Are national health check-ups just a prescription for chaos?" P11 Laurence Buckman quote 3/4 East London Advertiser "Working but under duress in pay battle" P22 Nuneaton Telegraph "Shake-up of GPs' services prompts public meeting" P23 Grant Ingrams quote Coventry Telegraph "Shake-up of GPs' services prompts public meeting" P23 Grant Ingrams quote Warwickshire Telegraph "Shake-up of GPs' services prompts public meeting" P23 Grant Ingrams quote Tameside Reporter "But spend it wisely says BMA" P25 Kailash Chand quote 6/4 Bedfordshire on Sunday Primary Care Trust prescribed longer hours before Department of Health P23 9/4 Shropshire Star "Many GPs contacted by private firm" P17 Laurence Buckman quote Oldham Chronicle GP pay award a slap in the face P21 Kailash Chand quote 10/4 Huddersfield Examiner Private practice fears P32 East Anglian Times (Essex) "NHS is too complex for patients" P8 East Anglian Times (East) "NHS is too complex for patients" P8 11/4 Manchester Evening News (1st ed) 130m for private firms to carry out NHS surgery P16 Kailash Chand quote Kent Messenger Service more efficient with Dr Perfect P15 Paul Hobday quote 13/4 Bedfordshire on Sunday Deceit over longer surgery hours P10 14/4 Western Morning News (Devon) Promise that GPs will open longer across West country P8 Western Morning News (Cornwall) Promise that GPs will open longer across West country P8 Exeter Express City doctors fury at Government move to extend surgery hours P5 Adrian Midgley quote 15/4 Western Morning News (Devon) Villages miss out on GP reforms P1,2 Adrian Midgley quote Western Morning News (Cornwall) Villages miss out on GP reforms P1,2 Adrian Midgley quote Exeter Express Johnson hopeful for plan to keep brilliant cancer service in city P8 Adrian Midgley quote Bournemouth Echo GPS shocked by health chiefs cancer claims P9 Tom McKinstry quote Oldham Evening Chronicle Cancer claims unfair on GPs P25 Kailash Chand quote 17/4 Stoke Sentinel Polyclinics slated P4 Shropshire Star Call for calm debate on bid for polyclinics P22 Peterborough Telegraph Doctors warning on super clinics P4 Grimsby Telegraph Concern voiced P6 Bolton News Call for calm in debate over super surgeries P4 Teeside Evening Gazette Slow clinic rush docs P6 Derby Telegraph Doctors voice fears over rush to super surgeries P10 Halifax Courier Super clinics warning P10 Cumbria News & Star Super Surgeries slammed P6 Reading Evening Post Polyclinics could undermine care P2 Laurence Buckman quote London Metro Doctors oppose rush in super clinics P4 Laurence Buckman quote Newcastle Journal Doctors concern at super surgery rush P20 Laurence Buckman quote Yorkshire Post Doctors voice fears over headlong rush to create super-surgeries P9 18/4 Lancashire Telegraph Warning over super surgeriesP11 21/4 Norwich Evening News Patients reassured over out of hours GP service P23 Laurence Buckman quote Western Morning News (Cornwall) Loss of family doctors big worry for patients P4 Laurence Buckman quote Western Morning News (Devon) Loss of family doctors big worry for patients P4 Laurence Buckman quote 22/4 Bournemouth Echo unease at plans for polyclinics P8 Tom McKinstry quote 23/4 Oldham Evening Chronicle GP surgeries in peril: Cameron P7 Kailash Chand quote Exeter express & Echo New GPs centre plan to improve city healthcare P17 24/4 Western Morning News (Cornwall) Bradshaw defends polyclinic proposals P5 Western Morning News (Devon) Bradshaw defends polyclinic proposals P5 Yorkshire Post Ministers aim to destroy GP services, say Tories P7 Selby Times Fresh fears in polyclinic row P7 Laurence Buckman quote 25/4 Birmingham Mail Sickening price of call to GP P13 Birmingham mail Sickening cost of call P13 27/4 Bedfordshire on Sunday "Listening and responding" p10 30/4 Southport Champion Fury over doctors fees P2 Formby Champion "Doctors charging 150 to sign form" P5 Broadcast 1/4 BBC Radio Berkshire "Choice" Jonathan Fielden interview BBC Radio Coventry "Extended hours" BBC Radio Gloucester "Screening" Laurence Buckman interview BBC Radio Manchester "Extended Hours" BBC Radio Newcastle "Screening" Laurence Buckman interview BBC Radio Nottingham "Screening" x2 BBC Radio Sheffield "Screening" Laurence Buckman interview BBC Southern Counties radio "Screening" BBC Radio Tees "Screening" Laurence Buckman interview BBC Radio York "Screening" Laurence Buckman interview BRMB FM "Choice" Fay Wilson interview KM FM "Choice" Laurence Buckman interview Wish FM "Choice" Laurence Buckman interview 3/4 BBC Radio Shropshire "Pharmacists" BRMB FM "Choice" Fay Wilson interview 11/4 BBC Radio Bristol Extended hours BBC Radio Oxford Image BBC Radio Oxford Image Prit Buttar interview 14/4 Wave 105.2 NHS admin BBC Radio Berks NHS admin BBC Radio Hereford & Worcester NHS admin BBC Radio Lancashire NHS admin BBC Radio Norfolk NHS admin BBC Radio Stoke NHS admin 16/4 Clyde Two 1152 AM Industrial action Moray Firth FM Industrial action x2 Northsound One FM Industrial action 17/4 Eagle FM Polyclinic BBC Radio Cornwall Polyclinic Richard Vautrey interview BBC Radio Cumbria Polyclinic Laurence Buckman interview BBC Radio Leeds Polyclinic Richard Vautrey interview BBC Radio Manchester Polyclinic Laurence Buckman interview x3 BBC Radio Newcastle Polyclinic BBC Radio Newcastle Polyclinic Richard Vautrey interview BBC Radio Oxford Polyclinic Richard Vautrey interview BBC Radio Shropshire Polyclinic BBC Radio Wiltshire Polyclinic Laurence Buckman interview BBC Radio York Polyclinic Richard Vautrey interview 19/4 Northants FM Polyclinics Richard Vautrey interview 24/4 Borders Radio Workforce Dean Marshall interview Clyde Two 1152 AM Industrial actionx2 Forth One FM Workforce Dean Marshall interview x2 Moray Firth FM GP workforce x3 Moray Firth FM GP workforce Dean Marshall interview Real Radio Scotland Industrial action Smooth Radio Pay Talk 107 GP workforce Dean Marshall interview STV Central GP workforce Andrew Buist interview STV Central GP workforce STV North GP workforce Dean Marshall interview BBC Radio Scotland Workforce BBC Radio Scotland Industrial action Dean Marshall interview x2 BBC 1 Scotland Industrial action 25/4 BBC Radio Tees Extended hours John Canning interview BBC Radio Wales Patient access x6 BBC Radio Wales Patient access David Bailey interview x3 BBC Radio Cymru Patient access David Bailey interview Parliamentary Report, Westminster Meetings: Roberta Blackman Woods, Labour MP for the City of Durham attended the Northern Regional Council meeting on Thursday 17th April. At the meeting, GPs from the North East of England shared their concerns about a range of issues currently affecting primary care including polyclinics and extended hours. Dr Stewart Drage attended a Kings Fund event on Monday 21st April at which David Cameron and Andrew Lansley, Shadow Health Secretary, discussed polyclinics and Conservative health proprosals for primary care. The All Party Parliamentary Group on Dementia published its report on the prescribing of anti-psychotic drugs to patients with dementia in care homes on Tuesday 29th April 2008. The BMA's Community Care Committee submitted evidence to the inquiry. A representative of the CCC attended the report launch to discuss prescribing practices and the care of patients with dementia. Five MPs and Peers were present at the meeting. Dr. Helena McKeown is scheduled to meet with Ivan Lewis, Minister for Care Services on Thursday 15th May to discuss the forthcoming Carers' Strategy. Debates: The Conservatives held a debate on Family Doctor Services on Monday 23rd April, which was very supportive of GPs. The Parliamentary Unit circulated a briefing paper amongst MPs, which was mentioned several times in the debate. It was also evident throughout the debate that MPs are being lobbied by GPs locally on a range of issues facing primary care. To read the debate, please go to: http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080423/debtext/80423-0011.htm#08042357000002 Hugh Bayley, Labour MP for the City of York, held a debate on NHS services in York on Monday 28th April. Mr Bayley made some very positive mentions about GPs in the debate. To read the debate, please go to: http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080428/debtext/80428-0022.htm#0804297000005 Legislation Health and Social Care Bill: The Parliamentary Unit continues to lobby Peers in the House of Lords on changes to the regulation of the medical profession. Criminal Justice and Immigration Bill: The Bill contains proposals to make it an offence to cause nuisance behaviour on NHS hospital premises. During the Bill's final stages in the Lords, Baroness Finlay, an independent peer, obtained a major concession from the Government to extend the Bill's current proposals on causing nuisance behaviour on NHS hospitals to Wales (previously this was only applicable to England and Northern Ireland). On a related issue, the BMA sought an amendment to ensure that the proposals extended to other premises (aside from NHS hospitals) where medical treatment is provided to the public by NHS staff members (e.g. GP surgeries). Unfortunately, the Government did not accept this amendment. Parliamentary Unit- helping GPs lobby their MPs Susan Solanki, Parliamentary Liaison Officer, attended the York and North Yorkshire LMC meeting on Thursday 8th May to advise GPs on how to lobby local MPs more effectively. Susan is scheduled to attend the Bradford and Airedale LMC meeting in June to provide similar advice. If your LMC would like further information on lobbying MPs, please contact Susan at ssolanki@bma.org.uk The All Party Parliamentary Group Scotland Press Releases: 24 April BMA Scotland warns of impending crisis in General Practice 24 April GPs call on government to deliver Scottish solutions for Scottish patients 24 April Scotland's GPs reject call for industrial action 25 April Leading campaigners in Scotland unite in calls for reduction in drink driving limits Media coverage: **Please note that SLMC Conference coverage is listed separately** Broadcast: 11th April BBC Radio Scotland Riddoch Questions Drs Brian Keighley, Dr David Sinclair, Dr Steve McCabe Extended hours Letters/Features: 11 April: The Herald  HYPERLINK "http://www.theherald.co.uk/features/letters/display.var.2189047.0.reneging_on_promise.php" Reneging on your promise: Your readers may be wondering why it is Scottish GPs are so exercised by what seems to be a reasonable recommendation by the Doctors and Dentists Review Body of approximately 2.2% increase in pay. Joint letter from current and former Chairmen of SGPC - Drs Keighley, Church, Garner, Harden, Love and Marshall 1 May: The Herald  HYPERLINK "http://www.theherald.co.uk/search/display.var.2238274.0.role_of_local_gps_in_tackling_heart_disease.php" Role of local GPs in tackling heart disease: Your report on the falling number of coronary heart disease deaths heralds a positive step towards improving Scotland's reputation for ill health [Heart deaths figures for deprived areas fall by 27% but total still lags behind wealthier areas, April 30]. (Letter from Dr Dean Marshall) 2 May: Press & Journal  HYPERLINK "http://www.pressandjournal.co.uk/Article.aspx/618867" Contribution of GPs. Sir, - Your report (April 30) on the falling number of coronary heart disease deaths heralds a positive step towards improving Scotland's reputation for ill health. (BMA letter - Dr Dean Marshall) 2 May: Courier & Advertiser  HYPERLINK "http://www.thecourier.co.uk/output/2008/05/02/letters.asp" Work should be recognised. Sir, - Your report on the fifing number of coronary heart disease deaths heralds a positive step towards improving Scotlands reputation for ill health (Drop in heart disease deaths, April 30). (BMA letter - Dr Dean Marshall) Features: The Scotsman:  HYPERLINK "http://thescotsman.scotsman.com/health/Online-resources-should-offer-more.4028828.jp" Online resources should offer more useful information. I recently flew on an American airline, and to pass away the tedious hours I picked up the in-flight magazine. (Monthly column by Dr John Garner) SLMC Conference 2008 Media Coverage The BMA press office published the conference agenda one week before conference this generated some advance publicity for debates at conference most prominent among these was the motion calling for conference to consider industrial action. In advance of conference, BMA Scotland published a new briefing paper on the GP workforce. This achieved a significant level of coverage on the morning of conference. Dean Marshalls speech to conference was published and obtained a fair level of coverage, in most cases this was within articles following up on the motion on industrial action. Overall this year the conference featured in 39 newspaper articles, including three front page stories. We organised 10 broadcast interviews and received numerous additional named mentions during local news bulletins*. We also achieved coverage in a number of online publications e.g. onmedica.net, medical news today, etc plus the medical press who were in attendance at conference (i.e. Pulse, GP, Scottish Primary Care and BMA News). (*the BMAs Scotland media monitoring service does not monitor local press or BMA mentions on broadcast channels) The Scottish Liberal Democrats and the Scottish Conservatives both issued press releases in support of the BMA during the conference: Lib Dem: SNP Undervalues GPs Finnie Conservative: GPs: No industrial action good but situation still bad Below is a list of interviews and articles Broadcast: 16 April Radio Forth Dr Gary Hamilton GP motion to take industrial action Radio Forth Dr Catriona Morton Contraception 17 April BBC Radio Scotland Dr Colette Maule Extended Hours 20 April BBC Radio Scotland - Sunday Live Dr Colette Maule & Dr Douglas Colville Preview of SLMC Conference 24 April BBC Radio Good Morning Scotland Dr Dean Marshall Workforce/SLMC Conference 24 April GMTV Scotland Dr Dean Marshall GP Workforce 24 April Radio Forth/Clyde Dr Dean Marshall GP Workforce 24 April Wave 102 Dr Dean Marshall GP Workforce 24 April Real Radio Dr Gary Hamilton GP Industrial Action threat 24 April STV News (Scotland Today) Dr Andrew Buist Preview of Conference Dr Dean Marshall Extended Hours/Industrial Action ______________________________________________________________________________ Press Coverage 29 April Scotsman (On the Rounds): News: GPs have called upon the government to deliver a Scottish solution to the question of extended hours in GP practice. 26 April Courier: GPs reject notion of going private 25 April BBC News online: GPs vote against strike over pay Times: Leading doctor accuses SNP over longer hours Sun: GPs say no way to action Herald: Scots doctors reject calls for industrial action on pay Scotsman: Angry GPs veto ballot Daily Record: GPs rule out strike Press & Journal: GPs vote against action amid concerns for patients Courier: GPs vote against strike action Daily Mail: GPs end strike threat Daily Express: Angry GPs say no to strike for sake of patients Metro: GPs vote against strike action plan 24 April BBC News online: Warning over GP staffing crisis Press & Journal: Scottish GP service in meltdown, warns BMA (Page 1) Metro: Family doctors in crisis claim (Page 1) Daily Express: Overworked doctors quit in droves as morale falls Daily Mail: Scots family doctor crisis Scotsman: BMA warns of health crisis as Scotland faces shortage of GPs Daily Record: GPs in strike action move Herald: Cancer testing system failing women (plus leader comment) Daily Telegraph: GPs urged to consider industrial action in pay dispute Daily Mail: 999 Cuts could put lives at risk Aberdeen Evening Express: GPs urged to consider strike action Aberdeen Evening Express (final edition): GPs say no to strike 20 April Sunday Herald: Doctors: Need for extra GP hours means nations working too much Scotland on Sunday: Out-of-Hours GP clinics to be cut Sunday Times: Too bitter a pill for doctors (Allan Massie Comment) 18 April Courier: Scots family doctors to discuss going private (plus leader comment) 17 April Scotsman: Doctors bid to sweeten pill (Diary piece) Metro: GPs consider industrial action over pay Daily Mail: Doctors cash call to treat migrants Daily Mail: Outcry after GPs say they are ready to go on strike Courier: GPs to consider industrial action Press & Journal: Doctors orders over pay Scotsman: GPs say longer hours a waste of resources Herald: Ambulance service at breaking point 16 April Daily Mail: 90,000 doctors want to strike over pay (Page 1) Dundee Evening Telegraph: Doctors urged to consider action Appendix 2 _    % & 7 > ? 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