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At the heart of general practice since 1960

As it happened: the first day of the LMC conference

17:30 And with that, the lights dim - perhaps a bit too quickly for some trying to vacate Logan Hall - and a vocal and defiant first day of conference comes to a close.

17.29 Conference unanimously backs a motion put by Dr Gregor Purdie, Dumfries and Galloway LMC, to reject use of the term ‘cottage hospitals’ by NHS management.

17:27 The motion, which urged GPC to reject OFSTED-style quality ratings, was passed overwhelmingly.

17:25 Dr Thomas Kinloch, says ratings reinforces target chasing. This highlights the irony this happening at the same time the health secretary is seeking recommendations on how to move away from targets.

17:18 Dr Tim Morton, Norfolk and Waveney LMC, urges GPC to reject the move to establish OFSTED style quality ratings of general practice, arguing a need for ‘more carrot and less stick’ approaches.

17.15 Dr Camphor refuses to take as reference - and the motion is carried in all four parts. 

17.05 Speaking against, Dr Anthony O’Brien slips up misnaming the CQC as the GPC, causing roars of appreciative laughter.   

Moving to the vote, Dr John Canning, GPC, cautions delegates against supporting the motion. He says CQC moving away from generic inspectors, looking to employ properly trained, sectorised inspectors for general practice who are listening to GPC. ‘While it may be true now, they are trying to change,’ he says.

17.03 Dr Ivan Camphor, Mersey, puts motion that CQC is not fit for purpose, slamming the organisation he says is now famous for its ‘ultra-light’ touch. It has major problems with back-office functions and public perception of its work, says Dr Camphor. He highlights that a recent CQC survey showed 11% of staff had been hit, mainly by managers and 30% bullied but says the QCQ did nothing.

17:01 GPC GP trainees subcommittee chair Dr Krishna Kashareni urges delegates to support the motion. ‘It’s time to get a move on, it’s time to sort this out once and for all.’ he said. The motion is passed, meaning the BMA will investigate the differences in pass rates.

16:53 Dr Saquib Anwar, Leicestershire LMCs, said delving into the figures is important. While white candidates have a pass rate of 91%, the rate for black and Chinese candidates are 76% and 69% respectively. The BMA has a role in pushing forward this ‘slow moving tanker’ he said.

But Dr Andrew Purbrick, Dorset, cautions against challenging the validity of the exam. It is an exam of basic competency. We should look into the reasons behind the disparities, he said.

16:44 Dr Williams admits the RCGP has shown transparency about MRCGP data, but says there needs to be ‘joined up thinking between the deaneries and the RCGP’.

‘We must support people who take brave decisions to take up positions far from where they call home. I want the training to take into account the struggle some of these international graduates face,’ he says.

Dr David Morris from North Wales LMC opposes the motion, as he believes there is nothing invalid about the MRCGP exam, and that there are people already looking into the reasons for lower pass rates among IMGs. He adds that in Wales candidates who might have problems with the MRCGP are identified and given help early on.

16:39 Next up is a controversial one - the MRCGP exam and specifically failure rates among international medical graduates.

The GPC’s Dr Chris Williams said ‘something is wrong with the way we teach our international medical graduates’.

16:39 A motion calling on LETBs to increase membership from general practice, consult with LMCs, not have open ended powers to request information from practices, fund a greater investment in GP training and increase capacity in GP training is… passed unanimously.

16:37 Dr Iain Bonavida, from Cleveland LMC, said funding for primary care teaching is under threat. Trainees still feel that general practice is the second choice and that GPs are failed hospital doctors, he adds.

16:28 The session on education and training is about to begin, including a motion on the controversial MRCGP exam.

16.20 Giving his final GPC Wales report, chairman Dr David Bailey says it’s been a turbulent six years. Despite ‘some still questionable clinical targets’, they achieved some significant wins in negotiating the separate contract this year - most important they achieved a back-track on MPIG phase-out, which was a huge threat to rural practices in Wales, he says.

Dr Bailey receives a standing ovation as he steps aside.

16.10 In his report on the year, Northern Ireland GPC chair Dr Tom Black highlighted that they are to take back out-of-hours commissioning, delivery and responsibility through CCGs - there will be no individual responsibility for GPs and their practices though.

16:10 Conference backs a motion from Grampian to congratulate the Scottish GPC negotiators for the changes they achieved with the GP contract

16:08 Away from the LMC conference, health secretary Jeremy Hunt has begun given his potential seismic address on the future of out of hours care at the King’s Fund:

We’ll be following that as it progresses, so keep an eye out on the website throughout the afternoon.

15:57 The conference votes in favour of a motion stating that longer consultations are impossible without a significant increase in funding.

15:53 Speaking against, Dr Helena McKeown, Wiltshire, says it is possible to increase consultation times. But this carries a word of warning - not without a cost of increased stress and longer hours. Dr McKeown and colleagues at her practice are starting work 45 minutes earlier each day to accommodate longer consultations.

15:50 Dr James Morrow, Cambs LMC, argues that consultations cannot be increased with the current patterns of investment and retention of GPs.

‘Against this backdrop it is impossible to increase consultation times. We’re already doing more and more for less and less,’ he says.

15:47 The conference votes against the part of a motion that says free at the point of contact care is not sustainable. However, it votes for the rest of the motion, which calls for a full and frank discussion about the future of funding.

15:43 Dr Jacqueline Applebee, City and East London LMC, argues against. We mustn’t give succour to the argument that we can’t afford a free health service, she says.

Dr Applebee adds we must not go back to the time people chose whether to feed their families or have treatment or go down the route of the US health service.

‘There is plenty of money in society - we mustn’t play into the hands of the Government that has brought us the Health and Social Care Act,’ she says.

15.35 Dr Richard Humble, Tayside, proposes a demand for a full and frank discussion on the funding of the NHS. There’s a lot of confusion amongst the public about how health care is funded, says Dr Humble.  He argues everyone needs to understand we need to pay more into the system through taxation if we are to keep the NHS free - we need investment to do that.

15.30 Speaking for the GPC, negotiator Dr Dean Marshall encourages delegates to support the motion. It’s important to speak to patients about what we can and what we should deliver, he says.

The motion is carried with large majority in all parts

15:26 Dr Gill Beck proposes a motion calling on the GPC to conduct a full public debate about what people want from the NHS. She says we know what the Daily Mail wants - 24-7 on all cylinders - while the Government wants Virgin Health plc. But we don’t know about what GPs want, nor the public, she says.

15:25 Motion 29, supporting the GP partnership model, is passed.

15:20 Dr Richard Vautrey, GPC deputy chair, says most will want to support - the choice for doctors needs to be there for salaried posts. However, he adds, equally there needs to be the opportunity for those who want to progress to becoming to partners.

15:15 Dr Sarah Khan, Herts LMC, proposes a motion championing GP partnerships and finding more flexible ways to help young doctors joining the profession.

15:10 The conference supports the motion and it is passed.

15:04 Dr Jenny Walton, Salford Trafford LMC, proposes a motion which says that LMCs have a ‘crucial’ role to play in the new NHS. Part of the motion demands the GPC addresses the issue of conflicts of interest generated by LMC members sitting on both LMC and CCG boards.

But Dr Miriam Ainsworth, Avon LMC, said that there are already processes in place aim to reduce the conflicts of interests faced by CCG leaders.

15:01 Birmingham LMC chief executive Dr Morley, who proposed the CCG membership motion, urges delegates to vote for the motion even if it would be impossible to carry out.

He gets the biggest laugh of the day - and maybe incurs the wrath of Mrs Morley - with his next argument. ‘Maybe the GPC is impotent, but if I won a date with Angelina Jolie & I was impotent, I’d still try to shag her.’

A close vote is called on this part of the motion, and it is lost.

15:00 Dr Anthony Brian, Devon LMC, wants the GPC to take whatever measures are necessary to abolish the requirement for all practices to be members of CCGs. This would send a strong political message to the Government with little impact on patient care, he said.

However GPC negotiator Dr Chaand Nagpaul said that this is too difficult a task as it would require the Government to repeal the Health and Social Care Act.


14.51 We’re about to start a debate on the future of general practice (part 1, natch), but we’re also keeping one eye on the King’s Fund, where health secretary Jeremy Hunt will soon be delivering his long-awaited, much-trailed speech setting out his plans for GPs and out-of-hours care. Pulse reporter Sofia Lind is on her way there now - Mr Hunt is expected to speak at 4pm, and will not be taking questions, we’re told.

14:32 Dr Hector Spiteri from Redbridge LMC says that performance management of GPs should not be transferred to CCGs. ‘They will just start arguing with each other and not form the cohesive group that is needed to make commissioning decisions’ he says.

14:25 A motion which calls on the GMC to reaffirm that commissioning GPs’ primary responsibility is to their patients, not to balance the books, is passed.

14:17 A motion warning that the ‘Government’s tendering rules will lead to an overly bureaucratic and time wasting process which will essentially disenfranchise GPs’ is passed. The motion also says that the standard NHS contract is more complex and burdensome than is necessary for a CCG to commission a service from its member practices.

Dr John Grenville, medical secretary of Derbyshire LMC, says of the standard contract: ‘After the first couple of hours it becomes mindnumbingly boring, but you have to carry on because youre only a quarter of the way through. If you want to tender you have to read it. Why do we have to use it?’

14.10 The GPC’s Dr Nigel Watson urges delegates to vote for the motion in its entirety. ‘If you’ve got one provider you might be alright, but if you’ve got 15 different ones you’ve got no chance of integration, he says. ‘In my area there are 18 musco-skeletal service providers. I’ve got no idea who they are, what they do, or what the quality’s like. So I have trouble referring to any of them because of what Francis has told me.’

The motion is passed unanimously.

14.08 Dr Amer Salim, from Merton, Sutton and Wandsworth LMC, takes to the stage to propose a motion which says that the introduction of Any Qualified Provider will affect patient care, increase primary care workload and is unnecessarily complex. He demands that CCGs should have the freedom to commission for the needs of their patients.

‘AQP will spawn a multitude of poor quality, cut-price services,’ he warns. ‘Continuity of care will be lost. Why undermine us by giving primary care funding to profit-driven businesses?’

14.00 The afternoon gets underway with an extended 40-minute session on commissioning.

13.30 Delegates at the conference have been extremely engaged with proceedings, but online and on Twitter, some notable exceptions aside, they’ve been a little quiet. And here might be why:

13.00 Conference breaks for lunch, after a packed morning. Overheard on the way out: ‘Everyone’s pretty angry. They haven’t really said what they’re going to do about it…’

Not an unfair assessment, all things considered. This afternoon should be interesting.

12.55 Dr Dean Eggit from Doncaster LMC puts forward a motion deploring the imposition the GP contract, with one part instructing the GPC to ‘investigate the legality of these actions through the European Courts and to take legal action against the Department of Health wherever this is possible.’

Dr Jamie Macpherson, from Coventry LMC, says GPs have a duty to speak up about the impact of the new contract on patient care as ‘whistleblowers’. ‘It’s our duty of candour and we should exercise this,’ he says.

Dr Alan Mills says the top-down bullying approach is ‘manifestly what Francis warned against’. But he argues against the idea of dragging the process through the European courts.

Stepping in on an emergency speaker’s slip, Dr John Canning from Cleveland LMC warns investigating legal avenues would cost an enormous amount and conference is persuaded. The motion is passed in all parts with the exception of looking at the legal process.

12.51 Dr Una Duffy earns a loud round of applause for a forceful speech, arguing that Jeremy Hunt is ‘itching’ to start drawing up a brand-new GP contract and that backing the motion would play into his hands.

She ends in style: ‘Never mind the “John Wayne contract”, this would be the “Clint Eastwood” contract. Do you feel lucky punk? Well go ahead and make my day.’

Conference decides that on balance it does not feel lucky, and rejects that part of the motion.

12.44 Dr Andrew Taylor from Liverpool speaks against the motion with a simply message. ‘Turkeys,’ he implores his fellow GPs. ‘Please don’t vote for Christmas!’

12.43 Dr Mark Durling from Sheffield LMC proposes a motion rejecting the current GP contract as ‘unfit for purpose’, and calling on the GPC to ballot GPs ‘on whether they should demand a new contract’.

He says there is no contractual mechanism for GPs to sustainably invest in stance and - perhaps mindful of the hall’s response to the previous motion - makes it clear he is not intending to criticise the GPC.

12:42 But some GPs believe it was right to have the debate:

 

12:41 It wasn’t a close vote, says Pulse editor Steve Nowottny:

12:40 The vote of no confidence in the GPC negotiators is lost.

12:35 Dr Buckman defends the GPC’s negotiations over the 2013/14 GP contract. They negotiated in good faith for five months before the Government pulled the plug. After that it was clear to the whole GPC - not just the negotiators - that the Government would not negotiate. Dr Buckman says they surveyed the profession and robustly refuted the Government’s claims.

12:34 Dr Laurence Buckman fights back strongly: ‘Don’t tell me I am not a grassroots GP. That is personally insulting and untrue.’

Dr Jeremy Cox, a GP in Hertfordshire, asks whether GPs did all they could to support the GPC. He says they did not.

12:30 Arguably the most controversial motion of the conference now - the vote of no confidence in the GPC negotiators for their role in pensions reforms and the contract imposition.

Dr Richard van Maellerts, a GP in London, proposing the motion, accepts the reception for Dr Laurence Buckman works against the motion.

12:18 One speaker calls on delegates to support the primary care workforce motion as heavy workload has led him to check out the cardigans in John Lewis, his eye on retirement. Another says that anything the DH comes up with will be the stick not the carrot: ‘What do you think the Government will do - up your pay, reduce your workload?’

12:07 Speakers are now hitting back against GP-bashing in the national press - some in dramatic fashion.

12:01 The queue to speak for this motion lengthens and lengthens. One speaker said his stressed colleague has recently retired to work in a coffee shop and is ‘loving it’. ‘We need these people in general practice, not leaving’ he warns.

11.59 There is a 20-person long queue of GPs waiting to speak for or against the primary care workforce motion.

One speaker asks conference not to ask the Government to ‘reduce the number of GPs retiring early’ as this could lead to unintended consequences. He said: ‘People don’t choose to go early if they love their job and want to stay.’

11:54 Dr Raj Menon from Leeds LMC takes to the stage as the section on primary care workforce begins. ‘Our patients need GPs, our country needs GPs, it’s time the Government worked with us and not against us,’ he says.

11.53 Calderdale LMC’s Dr Ben Wyatt asks conference to reject the GP appraisal motion and engage with their local responsible officer - but the motion is carried. GPC negotiator Dr Dean Marshall says there are ‘huge variations across the country’.

‘We have to have a board where concerns about appraisals can be raised.’ he adds.

11.52 Proceedings are continuing full tilt on the conference floor, but a number of delegates have snuck out for an impromptu coffee break.

Some delegates have come dressed for the occasion too:

11:46 Dr Sarah Gray from Cornwall and Isles of Scilly LMC proposes a motion which calls for a nationally agreed standard of evidence for GP appraisal in England and a national board to ensure appraisals are consistent. But Dr Adam Skinner, from Kent LMC, asks delegates not to call for another ‘overarching set of busybodies’.

‘Aren’t you satisfied with the number of inspectors already?’ he says. ‘Don’t ask for more.’

11.40 Delegates are falling over themselves to lambast the poor performance of NHS 111, in ever more eloquent ways. ‘A shambles, a complete disaster and waste of money’ about sums it up.

Motion 14, calling for the Government to ‘commission an independent enquiry into the NHS 111 debacle’, is carried unanimously. ‘Please keep the war stories coming,’ says GPC negotiator Dr Peter Holden.

11:38 Dr Nick Morton, from Norfolk LMC, reports that in his area paramedics and GPs were put into place to back up call takes in the NHS 111 call centre which led to improved satisfaction.

‘The DH said we couldn’t secondary triage, so we sense checked. We said we should have a GP in every call centre for a similar sense check,’ he says.

‘The DH is inept. NHS is a trojan horse, GPs beware.’

11.37 RCGP chair Professor Clare Gerada is in the auditorium, and enthusiastically tweeting proceedings.

11.33 Delegates are now turning their attention to the troubled NHS 111 service. Dr Mark McKenzie, from Northants LMC, says 111 actually stands for ‘one hundred and eleven questions’, referring to the thorough nature of call handlers’ questioning. Big laugh from delegates.

11:23 Dr Fiona Armstrong from Kent presents a motion for the GPC to ban CCG gagging clauses, highlighted in a Pulse investigation, and to ensure that GPs are fully able to blow the whistle about standards of care their patients receive.

The motion is passed.

GPC says it has put up a confidential helpline for GP whistle blowers.

11:18 Dr Richard Vautrey, GPC negotiator, says GPC does not entirely support everything in Francis and has concerns over the ‘duty of candour’, which could have negative consequences for GPs.

11:08 Dr Duncan Bardner, Devon LMC, proposes motion 11, saying Health and Social Care Act has little evidence base and has led to unnecessary upheaval in the NHS.

He asks whether we actually ‘need an Act for these policies to happen’.

‘Sadly much money has been spent on reorganisation - our focus should be on what work we should have done better, not on changing everything,’ he adds.

‘Is the NHS safe in the government’s hands? I think not’ he says.

Dr Chaand Nagpaul adds: ‘There is zero evidence for this wholesale reorganisation of the NHS.’ The £3bn spent on this is ‘a scandalous and irresponsible waste of resources’, he says.

The motion is carried unanimously.

11:00 The crowd listens on intently.

LMC 2013 crowd online

Source: Jon Enoch

10.55 Speaking against, Dr Sarah Morgan, from Bro Taf LMC, points out that GPs have been operating as private contractors since the beginning of the NHS and still provide care free at the point of access.

But speaking for the motion, Dr Ivan Camphor, from Mid MerseyLMC , says it’s sad to see so many GPs disaffected and looking forward to retirement. The level of private provision deserves a full public inquiry, he says.

‘We need to be vigilant about the growing private market and not be complacent about problems of commercial confidentiality,’ he says.

Responding to criticisms that the GPC needs to defend the profession from the media, Dr Buckman retorts that they have been doing pretty well - not easy against the Daily Mail, he says to loud cheers.

But he endorses the motion, which is carried by a huge majority - just one or two green cards go up against.

10:59 GPs on Twitter react to the motions on the Health and Social Care Act:

 

10.50 Dr Francesco Scaglioni, Cornwall and Isles of Scilly LMC, speaks to a motion saying the Government wishes to privatise the NHS and demands it is made public knowledge - the health act amounts to fraud, he says.

10.47 Dr Chaand Nagpaul, GPC negotiator, urges delegates to support Motion 9, which states that the lack of investment in primary care is negatively affecting the reforms. 

He says the progressive disinvestment in primary care will result in soaring secondary care costs and the agenda of moving care out of hospitals will cause the system to collapse. The motion is passed in all parts unanimously.

10.42 Dr John Crompton, from North Yorkshire LMC, steps up to propose a motion arguing that the reforms are an exercise in cost-cutting and rationing and will undermine the quality of care - and that general practice could be the solution to efficiency savings.

‘If we can provide 80% of consultations on 10% of the budget, how much more could we do [on more]?’ he asks

Dr Crompton says the NHS needs to stop fragmenting and undermining general practice, and primary care needs sustained investment instead.

10:41 Motion 8, which stated that the Health and Social Care Act is putting patient safety at risk, is passed unanimously.

10.37 Dr Gerard Reissman, Newcastle and North Tyneside LMC, says it’s going to be the poor who will really suffer from the reforms. We want to send a clear message we know what the Government is up to - we’re watching this car crash and we’re saying it’s happening, says Dr Reissman.

10.35 Dr Peter Madden, Cheshire LMC, speaking for, says policy appears to be to bring costs down to the lowest common denominator. He says the unilateral imposition of changes to pensions means all practices are under threat - with workforce problems looming the profession is heading for a ‘perfect storm’.

‘Do we jump before we are pushed?’ he asks.

10.34 Dr Paul Roblin from Oxfordshire speaks against. While we want to have a ‘pop’ at the Act there are much wider causes of the problems that society and general practice faces, he says. He recommends taking it as a reference.

10.33 After Buckman’s barnstorming speech and recepetion, Dr Beth McCarron Nash, Cornwall LMC, steps up to put forward a motion condemning the NHS reforms. She says GPs have little more control than we had before’In fact we have the worst of both worlds.’

10.31 Very warm reaction to Dr Buckman’s speech from GPs in the hall.

10:29 Dr Buckman begins to thank all involved in his reign as GPC chairman. ‘I’m going back to my practice before the Government can bankrupt it,’ he said. We should celebrate an ageing society, rather than be troubled by it, he said. An ageing society is largely down to the excellent care provided by GPs. 

‘It’s time the Government praised what we and our contract have delivered. That’s something that stands well clear of the often-grubby world of politics’ he said.

He receives a standing ovation for at least five minutes and shouts of ‘more!’

10.24 Applause, a standing ovation and even whistles greet the end of Dr Buckman’s final speech as LMC chair.

10:19 Delegates boo at the mention of a chief inspector of primary care. There are some appraisers who view their role as enforcers, punishing those who don’t fit in with their view of what a GP should be, warns Dr Buckman.

10:17 Dr Buckman paints a bleak view of the NHS’ future according to the Government’s current vision. ‘Competition rules the roost, tenders won by the lowest bidder with little regard to quality,’ he says.

10:13 ‘We never agreed to this nonsense,’ Dr Buckman says about the lack of modelling of the new contract. The lack of protection of PMS budgets means some practices could close.

10:09 Dr Buckman rails against the Government’s rejection of the DDB’s recommendations which resulted in GPs being handed a real-terms cut in income. Politicians do not listen, he says to applause.

10:06 Dr Buckman receives lasting applause as he said GPs are not prepared to back a system that has been ‘rendered unsafe by unwise political meddling.’ He said the GPC warned the Government they couldn’t keep patients out of hospital with a cheap service which used a call handler to nurse ration of ten to one. 

10:05 Dr Buckman takes to the stage for his last ever speech as GPC chairman. He hits back at Jeremy Hunt’s GP-bashing. The Government’s own analysis shows the causes of the pressures on A&E departments are complex; due to staff shortages and the botched introduction of NHS 111, not failures in OOH primary care.

10:00 Dr Mike Griffiths, Gwent LMC, opposes the motion as he says it presumes to read the mind of the Government. Jeremy Hunt is on record as believing the NHS is a 60 year old mistake, he said. He said the Government is not interested in a cheap option, they’re interested in privatisation and taking health off the state’s budget. He called on the conference to take the reference as a motion.

The motion is passed unanimously.

09:57 Dr MacFarlane receives raucous applause from delegates at the conference.

09.55 Dr Denise McFarlane from Grampian LMC takes to the stage to propose a motion which says that general practice provides superb value for money but that the Government is interested in a cheap option rather than investing in an option that could solve many of the NHS’ problems.

‘It costs more to insure a cat than the Government gives GPs per patient per year’, she says.

09:50 There will be a major debate from 3.30pm to 4.10pm tomorrow in reaction to health secretary Jeremy Hunt’s speech to the King’s Fund this afternoon. LMCs should submit motions to be debated by 10am tomorrow.

09.40 Dr Guy Watkins, chief executive of Cambridgeshire LMC, tells the conference that many motions were submitted in response to health secretary Jeremy Hunt’s upcoming speech, leaked to the press, in which he is expected to say GPs should take back out-of-hours care.

09.38 There’s some rearrangement of the agenda to take account of this week’s pressing business, namely Jeremy Hunt’s keynote speech later. The agenda committee are running through motions…

09:35 The 2013 annual conference of LMCs begins, and the hall is packed. LMCs submitted a record 911 motions to the agenda committee this year.

09.25 A rather unfortunate technical hitch means Pulse’s site has been down for much of the morning - but we’re back, and just in time for proceedings getting underway.

Most of the Pulse team is here in Logan Hall at the Institute of Education in central London - we’ll all be posting updates to this live blog, but you can also follow Steve Nowottny, Jaimie Kaffash, Sofia Lind, Madlen Davies, Caroline Price, Jessica Baron and Cat Attfield on Twitter as well.

06.00 Good morning and welcome to Pulse’s live blog from the first day of the 2013 LMCs conference.

Today looks set to be a crucial day for general practice. It’s not only the LMCs conference, but with impeccable timing health secretary Jeremy Hunt will also be delivering his much-trailed speech on a ‘return to the family doctor’ - and might just give some all important detail on how he expects GPs to ‘take back responsibility’ for out-of-hours care.

As ever, we’ll be bringing you all the latest news, views and emergency motions from the conference floor, as well as analysis from our reporting team and plenty of behind-the-scenes atmosphere, and we’ll also be covering Mr Hunt’s speech at the King’s Fund, which is scheduled to get underway at 4pm.

Readers' comments (7)

  • Just waiting for an excuse from the government, GMC, RCGP, that pushes me into action to emigrate and leave the country for good. We are fortunate enough to be in a career which is much needed in many coutries, often with better quality of life and pay. I don't see the situation improving at all. We need a collective forceful response. Vote with your feet!

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  • Did anyone spot the multi-millionaire private GP Dr Martin Scurr at the conference??? He has lots of moral advice and lessons to offer NHS GPs apparently!!

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  • Sorry to add, Dr Scurr is The Daily Mail's GP and moral advisor on NHS GPs.

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  • Can we have a debate on greed and private, lucrative General Practice for celebrities versus working in an area of deprivation trying to serve people who society does not care about and makes their lives better??

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  • Who cares what "Hunt" thinks! He talks crap most of the time anyway. Ask him questions about his priviledged upbring and time at Charterhouse school. Lazy, multi-millionaire.

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  • People talk about passing a motion-well the amount of motion that Mr Hunt talks surpasses all expectations.

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  • Looks like a lot of wind very hot but no real motion to rid us of the increasing burnout, inspections and cuts to income

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