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GPs go forth

'Several LMCs' to call for mass resignation and industrial action

Exclusive ‘Several’ LMCs will call for mass resignation and industrial action at the special LMC conference next month, Pulse has learnt.

Shropshire LMC – which led the calls for a special conference to discuss the sustainability of general practice – has submitted a motion calling for industrial action, and has said there are ‘several’ LMCs who are doing the same.

Pulse has already reported that former GPC negotiator Dr Peter Holden is submitting a motion on industrial action and undated resignation letters through Derbyshire LMC.

But the motion from Shropshire LMCs suggests that there will be a groundswell of support for such measures at the conference on 30 January, if the conference agenda committee puts it in the agenda.

It comes as a Pulse survey this month revealed that half of GPs would be in favour of mass resignation from the GP contract in protest at the state of general practice.

The Shropshire LMC motion says that general practice is in crisis and that it is ‘shameful’ that the policies of successive governments have led to this situation.

The motion ‘requests the GPC to canvass the willingness of GPs to submit their undated resignations if a speedy and appropriate response is not forthcoming.’

It also says ‘the use of sanctions should now be considered and requests that the GPC explores the realistic options for industrial action’.

Shropshire LMC medical secretary Dr Ian Rummens told Pulse: ‘Shropshire LMC initiated the call for a special conference.’

He added: ‘[The motion] is supported by several other LMCs. Inability to recruit means that practices are failing across the country, which in turn risks de-stabilising neighbouring practices and the prospect of meltdown in the very near future.

‘We believe that, unless GPs are prepared to take action, the Government will do nothing until it is too late.’

However, former GPC chair Dr Laurence Buckman said that industrial action and mass resignation wasn’t the right method to achieve change.

He said: ‘Taking industrial action is not the way to persuade the Government to do what you want to do, which is take the pressure off general practice.

‘The Government and its policies have piled on the pressure and it is important to point that out to the general public, and that is the point of this conference.

‘It is to explain how dangerously near the cliff edge general practice is in this country.’

Motion in full

That Conference:

1) Believes the NHS in general, and General Practice in particular, is in crisis.

2) Views as shameful the failure of successive Governments to recognise and address the issues that have led to this position.

3) Demands the Government urgently implements measures to relieve the intolerable pressures on General Practice.

4) Requests the GPC to canvass the willingness of GPs to submit their undated resignations if a speedy and appropriate response is not forthcoming.

5) Believes the use of sanctions should now be considered and requests that the GPC explores the realistic options for industrial action.

Readers' comments (43)

  • Fighting over a dead carcass...again!
    In third world countries, this service turned Private ages ago, which what the DoH is doing ...whether you like it or not.

    As GP's you will learn your place...as always!

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  • 31st of March is a good date for resigning from contracts - all we need is coordination. I am a premises owner and understand that one can lose rents but then so be it. We can't let the government slave drive us for an eternity.
    It's coordination that is needed or else we will end up as every year having a Contract by NHSE thrust below our noses on the 30th of March to sign without time to even read it. And then will begin another year of agony!

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  • Industrial action and threat of mass resignation is the only way to knock some sense into these idiots supposedly "in charge" of the NHS.

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  • Alex Grieve | Work for third sector21 Dec 2015 12:09pm - I don't need to troll you. If a service is unsustainable, no ammount of professional pride will pay the bills. You get what you pay for.

    To all others:
    - Don't just threaten, set the terms and do it if they aren't met.
    - If the current unsustainable contract is the alternative, frankly, what have you to fear from jumping ship?
    - Your patients trust you and want you to serve them.
    - The legal responsibility to provide the service will either compel the government to change the law, or to buy it back from you. Either way, you will take charge. Who else will they fly in - I don't see anyone waiting with an army of staff to deliver this overnight?
    - If you rent a building, carry on, do your maths, and figure out what you'll need to charge to pay yourself properly, and your bills. You are one of the smartest groups of people in the world - so let's show it.
    - The only things you think are assets (your contract and building) are currently liabilities - they take cash out of your pocket, rather then putting it in it.
    - Don't be the tail waiting for the Juniors to wag you - be the head. Their negotiations have stalled on a half-promise. Learn from their wins and losses. If you get this right, they will form chambers and do the same.

    The NHS is dead. Long live the NHS.

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  • ps.
    - At present you risk sits entirely with you. Form Ltds and TUPE all your staff, transfer all your other costs and liabilities.
    - If you wait to go bust as you are, you'll loose everything. Worst case, if you went bust in the new world, you'd walk away from it. That in itself is worth it.

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  • The way forward is to set up a business plan on the basis of already functioning small private surgeries.
    You have the space, you can rent out rooms while manning the reception with your existing staff, doing a few sessions yourself and maximizing usage.
    The key thing here is to keep up to required standards of service and have a secure IT Provider,
    reasonable rates for consultations and widen services. If the rates are kept at 1/2 of existing big companies, you will still survive comfortably. Surgeries in London charge £75 - £100 fee for seeing a Consultant while at BUPA or BMI you would expect to pay a £160-250.
    London imaging can do MRIs for £200 while in most of the clinics rates are 400 and above.
    It's a question of working the logistics.
    I have run my own clinic for a few years in a different country and can comfortably say - the beginning it may be slow to catch up but within 6-12 months one could be running in full capacity.
    Worth a try.
    Keeping GP rates competitive will certainly keep patients availing the service.

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  • Una Coales

    @Andrew thanks for the historical input.

    Undated mass resignation also worked for GPs in 2002. http://www.dailymail.co.uk/news/article-50579/Many-GPs-resign-NHS-reforms.html

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  • Una Coales

    Can we ask Hamish Meldrum to come back?

    "Many GPs would resign over NHS reforms
    A majority of GPs is ready to resign from the NHS unless new contracts are in place by next year, a British Medical Association ballot showed today.
    The threat of the mass resignation of thousands of family doctors from the health service comes just days before the General Election, and shows the medical profession's level of frustration at the slow pace of NHS reform.
    The BMA ballot asked all 36,000 GPs in the UK if they would be prepared to submit an undated resignation letter in April next year if the Government had failed to agree on "significant and acceptable" reforms to the 50-year-old GP contract.
    Doctors are frustrated that despite a pledge in the NHS Plan that contracts would be reformed, ministers have so far failed to start negotiations.
    Two-thirds of doctors responded to the ballot.
    Nationwide, nearly nine out of every 10 of those who responded - 86% - said they would be willing to quit.
    In Scotland 69% responded, of whom 84% said they would consider quitting.
    In England the response rate was 65%, with 86% voting yes. In Wales the response rate was 63%, with 87% saying they would be prepared to resign from the health service.
    In Northern Ireland, 67% of family doctors responded - with a massive 90% indicating that they would resign if new contracts had not been agreed by April 2002.
    Dr Hamish Meldrum, deputy chairman of the BMA's General Practitioners Committee, said: "The message this ballot sends could not be clearer or louder.
    "The result demonstrates the depth of disenchantment, despair and disillusion felt by GPs throughout the UK.
    "Regrettably, they dramatically confirm what we have been telling Government's for years, that general practice is at the end of its tether."
    Doctors want the new contracts to reduce the amount of bureaucracy and administration they face, and to define their roles and responsibilities more clearly.
    They have also been increasingly critical in recent years over the growth in workload caused by Government initiatives and reforms, which they say have left them with less time for patients.
    The average GP now conducts more than 10,000 consultations a year and spends just eight minutes with each patient.
    The ballot is not a vote on industrial action but does demonstrate the level of frustration at the Government among GPs.
    The NHS Plan promised an extra 2,000 family doctors by 2004, but the BMA estimates that England alone needs 10,000 more family doctors to ease workloads on the profession.
    According to BMA figures, there were only 113 new GPs last year - and many of them would not be working full time.
    Dr Meldrum said: "Morale among GPs has never been lower, workloads and expectations never higher.
    "There has been a persistent failure to provide the level of resources at practice level to enable family doctors to treat their patients properly or quickly.
    "GPs want more time with their patients to provide a first class service. Now it is the incoming government's turn to provide time for general practice."
    The ballot comes a day after hospital consultants warned that increasing workloads were preventing them from delivering quality care in the NHS.
    While the BMA said it wanted to negotiate with the Government over new contracts and avoid any resignations, the threat of thousands of GPs leaving the NHS next spring could cause chaos.
    Dr Meldrum said: "I think we can make a lot of progress and find solutions and prevent what would be a disaster for the health service."
    Doctors who resigned from their NHS contracts could work for the health service in other ways, he said, although he declined to explain what these could be.
    And Dr Meldrum admitted: "It may in the short term be a more limited service, depending on what clinical care we are able to give.
    "It is possible that private work may be an option.
    "It could be that some GPs choose to do that."
    Dr Meldrum said: "The present arrangements under which most GPs contract to provide medical services are failing both GPs and more importantly our patients.
    "We believe that we need to reduce bureaucracy and ensure a contract that is based on quality of service rather than a number of patients on a GP's list."
    He said doctors were "profoundly disappointed" at Government delays in negotiating new contracts and responding to other concerns about NHS reforms.
    Dr Meldrum said: "The intention was not and is not to encourage GPs to throw in the towel.
    "It is to highlight the fact that primary care is on the edge of an abyss of collapse due to a failure of recruitment and retention which has not been addressed by successive governments.
    "The GPs of the UK have today sent a wake-up call to the politicians."
    Family doctors said they could spend between two and three hours a day on bureaucracy and administration.
    Of Labour's handling of the health service in the last four years, Dr Meldrum said: "In many ways they have started to put more money into the NHS but they have failed to address the problems of bureaucracy and have failed to understand just how deep the problem is in general practice."
    Dr Kenneth Harden, head of GPs in Scotland, said that problems there stemmed from the shortage of doctors in isolated, rural constituencies which meant GPs were often constantly on call.
    "We are very keen to enter into discussions with the Government.
    "They will find us willing partners who want to find a way forward."
    Dr Tony Calland, head of family doctors in Wales, said difficulties there were especially highlighted in the valleys, where there had been an influx of Asian doctors in the 1960s who were now coming up to retirement age.
    "There is going to be a very substantial loss of GPs in the Welsh Valleys," he said.
    "Unless there is an attractive contract there will be large parts of the Welsh Valleys which may have difficulty in providing a primary care service."
    Areas of mid-Wales which are largely rural are also experiencing chronic recruitment and retention problems, he added.
    In Northern Ireland, Dr Brian Patterson said the political situation had stalled the process of setting up primary care groupings and had led to increasing disillusionment among GPs.
    Doctors who said they would not be prepared to resign had done so partly because they feared they would bankrupt themselves if they did quit, he claimed.
    "It is frightening because the results of this ballot mean that the profession in which I work and value is now under severe threat."
    A spokeswoman for the Labour Party said home visits by GPs had fallen by half and night visits by one third since 1990, while the number of family doctors had risen by 9% and there had been a 40% increase in the number of practice nurses.
    She said: "We recognise that the jobs that GPs throughout the UK are doing and we are keen to negotiate new contracts.
    "We want a GP contract which reduces bureaucracy and improves patient care."


    Read more: http://www.dailymail.co.uk/news/article-50579/Many-GPs-resign-NHS-reforms.html#ixzz3uxkhHd39

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  • The junior doctor -ACAS negotiations are not going anywhere and very likely to strike in Jan before the present mandate for strike runs out.
    It would be to the GP's advantage to have this meeting early and hit the iron while it's hot.

    We need a few but high impact strikes.

    GPC also needs to to look at non-NHS options before this.

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  • If you want to resign then there need to be a credible plan b. Without that, the government would call our bluff and many would not sign on to undated resignation. Start talking about alternative models and the government will back down. But of its hot air then you have nothing.

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