Paranoia is once again striking sections of the nursing profession. We are seeing defensive territoriality dividing the profession in the face of the most recent onslaught - the GP contract ( 1 ) which took effect on April 1 this year. This reaction is hardly surprising given the way changes have been handled. When fundamental changes are proposed and implemented with little or no room for negotiation, piloting, experimentation or refinement, then what can we expect but a backlash of opposition in the face of such an apparently immovable force?