All you need to know about GP politics
Medical politics can be wildly interesting to a minority of GPs and deadly boring to the vast majority. The only problem is that it is very important to the everyday working lives of more than 40,000 GPs in Britain, and very soon you will appreciate the impact it can have on your life.
The BMA is the largest of the medical trade unions (professional bodies) and is registered as a trade union under the trade union and labour relations legislation enacted by the Conservative government in 1984. Some 90 per cent of all doctors are members of the BMA, which is split into different craft committees:
l General practitioners committee
l Consultants and specialists committee
l Junior doctors committee
l Public health and community committee
l The armed services medical committee
l Medical academics services committee
Each craft committee negotiates with the Government for the conditions of its members, but only the BMA is allowed, under trade union legislation, to call any form of industrial action.
Having finished your registrar year and received your practising certificate you can choose how to plan your route to become a future chair of the BMA.
Become active in your local medical committee
Every area of the UK has a local medical committee (LMC). LMCs were set up in 1911 to represent local GPs and have a statutory function with respect to the local division of the NHS, currently primary care trusts (PCTs). If you are a principal in a practice, whether singlehanded or a group, you will pay a levy to the LMC. If you are a non-principal you can pay a levy to the LMC in whose area you mainly practise or live, which will allow you to take part in the LMC's activities including standing for the committee or even the GPC.
Part of your LMC levy will pay for the running of the GPC, which also receives funding centrally from the BMA. You don't have to be a BMA member to be an LMC subscriber, LMC committee member, GPC member, or even chair of the GPC.
LMCs will have increasing importance now the new GMS contract is in place because parts of it, such as the 'enhanced services' section, will have to be negotiated between the LMC
For a new GP, having the protection of your LMC can be invaluable if you have problems with patients, other doctors, or your PCT, because it is likely that someone on the LMC has faced your problem before and will help you deal with it.
Many LMCs run mentoring schemes, whereby a newly qualified GP is placed with a mentor of their choice to discuss their progress in general practice, and help them develop their medical career.
All GPs must now be regularly appraised, and revalidation is around the corner. LMCs are helping to make this process as painless and friendly as possible, while helping to maintain good practice and standards.
Become active in your local BMA division
The BMA division is a local group of GPs, consultants, junior doctors and others, and is a good way to meet other doctors who work in your area and are not GPs. The division often organises social activities, but you may feel this is not your scene. By being a member of the BMA you are automatically a member of a local division. The BMA division sends representatives to the annual representative meeting (ARM), which is held annually in late June or early July and formulates policy for the BMA. You could be one of these representatives sent by your division.
The Medical Practitioners Union
The Medical Practitioners Union (MPU) is a trade union, separate from the BMA, and affiliated to Unison. It believes GPs should be salaried. Two representatives from the MPU sit on the GPC and provide refreshing insight into the work of the GP from a different perspective.
The General Practitioners Union
The General Practitioners Union (GPU) was formed last year by a group of GPs who felt the GPC was not listening to GPs' concerns over the new contract. It is a fledgling organisation that is currently trying to scrap the new GMS contract on the basis that it was unpriced and unfinished when GPs were asked to vote on it. The GPU has mounted a legal challenge and awaits the outcome of the judicial review.
The National Association of Non-Principals
Many new GPs no longer join a practice as a principal but prefer less restrictive ways of working, such as being locums, assistants or salaried partners. This is often as part of a portfolio career, combining work with other commitments. The National Association of Non-Principals has representatives on the GPC and works hard at maintaining national standards for locums and assistants, including indicative pay rates. It was instrumental in helping the BMA achieve pension rights for non-principals.
Medical Women's Federation
The Medical Women's Federation represents women's issues throughout all branches of medicine and has campaigned strongly, helping to sort out problems such as maternity pay for GPs.
The British International Doctors Association
This body (formally the Overseas Doctors Association) has many members among doctors who trained in the Asian sub-continent before coming to practise in the UK. It is at the forefront of countering racism in the NHS. It has now expanded to include all non-UK graduates, and helps sort out the problems these doctors may have. It is also represented on the GPC.
Can I be bothered?
Can you be bothered, or should you be bothered? You are entering general practice at a time of great change and uncertainty and it is easier to make the journey through your career with the support and help of your colleagues. In return, you might want to help and support them. So, if you want to influence or change the status quo, and you have the energy to go with the ideas, then join up, somewhere. We are waiting for you, and you will be encouraged in your efforts.
Bedfordshire & Hertfordshire LMCs
Berkshire & Buckinghamshire LMCs
Bro Taf LMC
Cornwall and Isles of Scilly LMC
North Staffordshire LMC
Somerset LMC www.somersetlmc.demon.co.uk
West Midlands LMC