As a profession we must consider whether we take a step we haven't taken since 1975. Most GPs who are BMA members will be receiving their ballot papers in the post this week. It's decision time.
We've arrived here reluctantly, and we would have far preferred to get to a fairer solution through negotiation. But the Government's refusal to consider any rethink of its unfair and unnecessary changes to the NHS Pension Scheme has left us with no alternative. If you have an NHS pension, you have already started paying significantly more than you were up until April, and a lot more than you would if you were a senior civil servant on the same income. If you are under 45, you are probably facing working to at least 68 to get anything like the current deal on retirement.
There are some doctors who believe what the Government is doing is fair, but I believe they are in the minority. The question now is not whether the changes to our pensions are justified, but whether we take industrial action to fight them.
We all put our patients before anything else, and clearly this is a very difficult decision for many. However, the model of action we are asking GPs to take has been very carefully thought through to have an impact, while still assuring patient safety. There are three key principles: that doctors attend their workplaces as usual; that all urgent and emergency care continues to be provided, but with non-urgent work postponed; and that we engage in advance planning for this action.
So if action were to go ahead:
• practices would remain open, for the same number of hours they would be usually
• patients considering themselves in need of urgent attention would get it that day
• you would continue to undertake urgent work such as reviewing test results and acting on abnormal results, and dealing with urgent prescription requests.
However:
• you would not handle routine appointments
• pre-booked appointments would be cancelled in advance
• you would not undertake non-urgent routine work.
The BMA will provide advice and support, but there would necessarily be some local flexibility. Each practice would need to decide how it would operate, discuss its plans with its primary care organisation, and ensure that the arrangements were well publicised to patients. GP partners would need to act reasonably in terms of what they ask staff to do on the day of action, but steps such as asking reception staff to operate a different system for booking appointments would not be unreasonable. Regardless of the practice's stance, we would urge all GPs to support colleagues who choose to participate.
Clearly, the action we are proposing does not constitute a full withdrawal of labour, and it's not strike action as the term would normally be understood. But the ballot paper contains two questions – one asking if you are prepared to take part in industrial action short of a strike, and one asking if you are prepared to participate in a strike. You should vote Yes to both questions if you want to give us a mandate to go ahead with the action.
Completed ballot papers must be received by post by the Independent Scrutineer, Electoral Reform Services Ltd, by 5pm on Tuesday 29 May. We need as high a turnout as possible, and I can't emphasise enough how important it is that you vote, and help us get the vote out by talking to colleagues. This is a critical moment for our profession – it's too important for you not to have your say.
Dr Hamish Meldrum is chair of BMA Council
