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Independents' Day

GP leaders face tough decision on industrial action in November

The BMA’s GP Committee is to decide in November on its next steps towards industrial action after its own survey found over half of GP practices would be willing to temporarily stop registering patients due to workload pressures.

GPC chair Dr Richard Vautrey told Pulse that ‘all options are on the table’, including potential industrial action that would involve balloting GP practices on whether to close their lists en masse.

The meeting of GPC England will consider whether the Government ‘are taking seriously’ the pressures in general practice and the results of its survey.

It conducted the survey to gauge whether there was any appetite for industrial action, following a motion at this year’s LMCs Conference.

The survey drew responses from 1,870 GP practices in England, the BMA’s GP Committee said, revealing that 54% would be willing to close lists to ‘focus on delivering safe care to patients already on their practice list’.

In addition, 44% of practices said they would be in favour of applying for a formal and permanent list closure from NHS England.

The GPC said the next step would be to take the result and bring it into negotiations with Government about GP terms and conditions.


Dr Vautrey told Pulse there were no immediate plans to ballot the profession on industrial action but ’all options are on the table’.

He added: ’It will be GPC England in November that will be considering the response that the Government are making, whether they are taking this issue seriously but it’s an issue for GPC England.

‘We will see what will happen over these coming weeks but when we get to GPC England it will be for them to consider what are the next steps based on the information that they will be receiving from their own constituents.’

He added that in places such as Folkestone, ‘practices are now reaching the point where they are closing their lists because they want to keep their patients safe’.

The Department of Health acknowledged that GPs ‘are under more pressure than ever’ but urged the BMA to consider how patients would fare if it were to put its threat of collective practice list closures into action. It suggested last year’s GP Forward View rescue deal was resolving the problem.

A DH spokesperson said: ’We are backing the profession with an extra £2.4bn of funding for general practice by 2020.

‘We speak regularly to the BMA about issues concerning general practice and would urge them to consider the detrimental impact which list closures could have on patient care.’

The BMA’s survey asked whether funding, workload and staffing pressures meant they needed to consider suspending new patient registration in order to protect patient safety.

It came after a motion at the LMCs Conference in Edinburgh this year stated it ‘demands that GPC ballot GPs as to whether they would be prepared to collectively close their lists in response to this crisis’.

At the time, now-GPC deputy chair Dr Mark Sanford-Wood warned that there were 'risks' with the plan, and that such action would ‘likely be a breach of contract'.

What happens next

The GPC is set to take the results of its survey into negotiations with the Government. This month it is also expected to update its Urgent Prescription document – its list of demands for general practice – which it will relay to NHS managers.

GPC England will meet in November and decide whether the Government’s response to its demands has been sufficient. GPC chair Dr Richard Vautrey said ‘all options are on the table’.

For any ballot result to be legal, a turnout of at least 50% will be needed, with the majority of those voting in favour of action. Recent changes to trade union law also specify the support of at least 40% of all members entitled to vote (ie, on an 80% turnout, a 51% vote would be acceptable).

There have been indications of how such action would be received, with an unusually measured Daily Mail front page saying GPs were considering taking the ‘drastic’ measures because of the pressure they were under.

But there is the possibility many practices will unilaterally close their lists anyway on the basis of GPC advice they have already received.

The idea of a mass closing of lists was first suggested by Pulse editor Nigel Praities.


Readers' comments (19)

  • Can a contract really be in 'breach' when enforcing it is likely to be unsafe? Surely the BMA should take some legal advice on this? Asking GPs to run list sizes of over 3000 is inviting calamity. I'm pretty sure any other industry would be in serious trouble if it attempted to write illegal contracts.

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  • Leadership from the BMA imperative.
    This is potentially a significant action which may have far reaching consequences. Remember the fate of the Junior Doctor "strike"!This could be far more significant.

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  • End of the line?

    All talk and no action
    spineless profession

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  • End of the line?

    and gov knows it

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  • Industrial action organised by the BMA? Hilarious, it worked so well last time. What we need is a plan to "do a dentist" and escape the NHS.

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  • David Banner

    The BMA should negotiate a "safe maximum" number of patients per full time GP, above which there could be no further registrations, either voluntary or compulsory. A chaotic and uncoordinated mass list closure is bound to fail as GPs are hopeless at acting as one unit.

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  • No negotiation involved setting a safe limit.... we are the experts in our own field.... we should debate it with experts from other industries (Not the government - remember their agenda is setting us up to fail ) .. and set our limits, and stick to them..... end of. We also need a publicity campaign to counteract the numerous think tanks set up by the private corporates to 'influence' policy their direction..... the spin doctors will be set upon us and we need to be ready for a dirty campaign from groups such as the Tax Payers Alliance ( they are anything but representative of normal tax payers,they are funded by Conservative backers to lobby in their best interests- hence their constant banging on about productivity, improve efficiency, reduce taxes... in theory it sounds fine but it is about running down the system to allow more profiteering at public expense...I must have mentioned this in about 4 articles now but they are a slick machine ready to send out stylised speakers to speak to the media about every issue on their behalf, but yet make it look like they represent the public.... the public needs to be made aware who they really are and their true interests. Dear Ed do a dossier on them)

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  • Everyone has their limits. A might happily see 40 patients a day but B might only manage 20. What feels safe for X might not be the same for Y.
    Instead of discussing numbers, limits etc, scrap the current contract and bring in pay per activity. Will solve most of the problems.
    Demand can only be addressed by charging for access... without exemptions.

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  • Are we then prepared for a scenario where we are Sat in the surgery twiddling our thumbs waiting for the punters to come in. No activity, no pay situation?

    If not, a salaried role with/without crown indemnity, set hours and serfdom awaits.

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  • A DH spokesperson said: ’We are backing the profession with an extra £2.4bn of funding for general practice by 2020.
    ..and then the spokesperson woke up. Hello? Where is the money? I suspect it will be announced on 31st Dec 2019 with an invitation to practices to bid for it. Oh, hang on, there wasn't much uptake, but we did offer it by 2020.

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