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Gold, incentives and meh

GPs declare rescue package 'inadequate' and vote in favour of industrial action

GPs will be canvassed on their willingness to sign undated resignations and take industrial action following a passionate debate at the LMCs conference this morning.

GP leaders at the LMCs Conference today voted in favour of a motion that said that they ‘not accept the General Practice Forward View is an adequate response’ to the crisis in general practice, and ’considers it to be sufficient grounds for a trade dispute’.

The motion, proposed by Dr Jackie Applebee, from Tower Hamlets LMC, follows the call for mass resignations in January, which gave NHS England six months to provide a rescue package.

GPC chair Dr Chaand Nagpaul said the motion was about a ‘democratic process’ to see where GPs stand.

Delegates had said that there was not sufficient urgency in the General Practice Forward View, while speakers warned it had failed by not committing any money to core GP funding.

Dr Applebee asked: ’Are we going to accept the demise of general practice? If not now, when? Will there be a general practice to defend if we wait much longer?

’The Government can always find money if the will is there, but is the will there? We have to remember that this is a Government determined to drive through austerity. [Dr Nagpaul] very rightly said yesterday that we must hold NHS England to account, but how?

’They may have belatedly begun to listen but the GP Forward View does not throw the lifeline that practices need right here right now.’

This vote is the profession’s most robust response over whether the General Practice Forward View is adequate as a rescue package.

GPC chair Dr Chaand Nagpaul said yesterday that the number of people leaving general practice suggested that mass resignation is ‘an impending reality, and not a threat’.

Speaking on the motion today, he said: ’The GPC are servants of the democratic process and that democratic process means representing 35,000-40,000 GPs, most of whom are not here today. 

’So for me this motion is about that democratic process. It is about actually asking GPs where they stand. I think we know where they stand, we know exactly what they are experiencing, but it is about actually for the first time getting a real idea of what they want us to do, and what they are prepared to do.

He added that this ’isn’t about threat. He went on: ’I think what is important is that people are leaving, and my proudest moment was, like many others have said, becoming a GP… and then I am sitting here and I am actually worried whether my practice is coping today. And I think many of you here today are worried about whether your practice is coping today.

’I’m worried about looking at my emails. I worry about the two weeks of holiday I would like to take this summer. That is the reality and I think that it is right that we find out from the profession their intent and the reality that is unfolding before us.’

Dr Andrew Green, chair of the GPC clinical and prescribing subcommittee, called on GPs to vote against the motion, saying junior doctors showed the level of support needed to make a stand - which GPs were unlikely to match. 

He said: ’What is the juniors’ greatest strength? It is unity. What would be our greatest mistake? To expose disunity. And that is exactly what a call for industrial action at this time would do. I’m sorry conference but we will not get anywhere near that magical 98% - and that will look like a defeat before we have even started.’

In January, the Special LMC Conference voted overwhelmingly to carry a motion proposing that ‘the GPC should canvass GPs on their willingness to submit undated resignations’ unless ’negotiations with government for a rescue package for general practice’ are ’concluded successfully within six months’.

Motions in full

AGENDA COMMITTEE to be proposed by Tower Hamlets: That conference does not accept the General Practice Forward View is an adequate response to the GPCs statement of need within the BMAs Urgent Prescription for General Practice, and considering this to be sufficient grounds for a trade dispute, unless the government agrees to accept the Urgent Prescription within 3 months of this conference, the GPC should ask the BMA to:

(i) ballot the profession on their willingness to sign undated resignations CARRIED

(ii) ballot the profession on their willingness to take industrial action CARRIED

(iii) ballot the profession as to what forms of industrial action they are prepared to take CARRIED 

(iv) produce a report to practices on the options for taking industrial action that doesn’t breach their contracts CARRIED

 

AGENDA COMMITTEE to be proposed by Cambridgeshire: That conference with regards to the General Practice Forward View;

(i) Welcomes the acknowledgment of significant past underfunding and commitment to increased spending CARRIED

(ii) believes that most of the investment promised is conditional upon practices delivering transformation and service change CARRIED

(iii) recognises that only some of the demands of the profession have been included, and instructs GPC to continue to press for further dedicated resources to support GPs CARRIED

(iv) does not believe that there is sufficient urgency in the measures described CARRIED

(v) is concerned that the present financial state of the NHS makes the prospects of these financial flows unlikely CARRIED

 

 

Readers' comments (87)

  • i think what Ivan is trying to say is that it will mean the end of the NHS as it can't exist without doctors?

    i beg to differ - even war zones have state healthcare - all that will happen is that there will be a smaller state health system (NHS lite) and a network of independent private GPs with funding streams from the consumer not the state. The laws of supply and demand will then take place i.e. market rates will apply. this will lead to greater funding for primary care and better services for patients.

    GPs who wish to work for the state can - but those who don't can work independently.

    this is a much better plan than poorly funded super-practices run by a few GPs managing support staff.

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  • 'all that will happen is that there will be a smaller state health system (NHS lite) and a network of independent private GPs with funding streams from the consumer not the state. The laws of supply and demand will then take place i.e. market rates will apply. this will lead to greater funding for primary care and better services for patients.'

    But surely what this will do is encourage doctors to work in the South East leafy suburbs where there are plenty who will pay for the service, and the poor run down areas in the North, where need is often the greatest, will be even more under doctored.
    I suppose I should be grateful that I am of an age where I could just walk away but I love my job and will always go the extra mile for my patients. Not a member of the BMA so of course my views are irrelevant anyway.

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  • Privatisation of Primary Care? Its already private.

    Its already run by thousands of independent partnerships, with almost all their income from government contracts.

    How can you fear privatisation of something that is already private?

    The problem for the government is time and again the GMS model of most practices is shown to be the most cost effective model. GMs and PMS are being brought into line and will leave the APMS contracts out on their own as the most expensive. Companies are handing back their contracts as unprofitable so if GP partnerships vote to resign you don't need a 90% vote. 10% would collapse the system!

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  • Every country needs healthcare. Healthcare costs money. A tax funded healthcare system like the NHS is a highly efficient way of providing this. If we move to a privately funded healthcare system it will cost the country as a whole a lot more cash and the service will be far less evenly distributed. Look at the USA. The rich will get what they want and everyone else - and that means most people - will be worse off and will have a lifetime of health related worry to deal with. As a country we need to be honest about how we want to fund our nations health care, we need politicians with the guts to explain why an efficient health care system is a good idea for the country as a whole and we need to be prepared to pay for it. The NHS is struggling because politicians lie about what the country can actually afford and massively underfund their hyperbole election promises. If we resign and go private that's bad news for the UK. It is perhaps what this conservative government wants but the privatisation of healthcare is good for no one but business. A privatised service will still need Drs and will pay for them. I'm a Dr so I might myopically conclude I'll be ok then, but one day I'll retire and be old, no-one else in my family is a Dr, my children won't be, my wife isn't, most of my friends aren't, we'll all be screwed by a privatised healthcare system. Maybe we need to threaten to resign to get the government to do something - but our aim should be to preserve our NHS - it's a great thing but it needs adequate and honest funding. Not the current Hunt bull.

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  • ?why wait : send the ballot paper now!
    we are a good 6500 patients practice and have not been able to recruit(no interest after 2 adverts) and one partner is leaving end sept,another partner going half time : I am mid 60 and I will throw in the towel as well

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  • With all the talk of the failings of GP forward view, I would like to know the position of the devolved health departments outside England, as far as I see it, at least you guys got something promised, it may not be great but it is a way lot more than is coming our way in Northern Ireland so far! Once again this is the National Health service that we are looking at, this includes more than just England, here we have been promised pharmacists to help out with our workload, no sign of more money or doctors though! 25 % of our GP workforce locally will be gone within 12 months in our county alone through retirement etc and still there is silence from local government

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  • @3:07- you have an important point there but tell this to the Eton boys and the political whores who are only interested in prospective top positions in private healthcare giants once they have liquidated the NHS. They give a sh*** to the fate of ordinary working people.

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  • Peter Mcevedy | GP Partner20 May 2016 1:55pm

    'the poor run down areas in the North, where need is often the greatest, will be even more under doctored'

    I work in the north as a locum and there is already very low staff numbers and we basically fire-fight each day. given that demand is set to increase with no new funding and no new staffing - things are set to get worse. there are, however, some affluent areas within the poorer areas - even in middlesbrough and Sunderland which could support small independent practices.

    My experience is that the poorest patients actually tend to be be the least demanding. It's the middles class and wealthy folks who feel because they pay in their £75 a year for primary care services then they want everything done now and perfectly.

    for example - i have a patient from a poor area who has knee pain with severe OA and has finally agreed to see Ortho to get it sorted and i have another patient at another site (middle class) who wants a referral even though there is nothing on the xray or no abnormality on examination or from physio assessment.

    moving to a part state and private system will mean that my poor (no disrespect) patient will get care and my worried well (middle class and wealthy) will have to pay for it.

    it's better than what we have now?

    so the worried well and heart sinks are catered for and the actually sick and needy will also be seen.

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  • Rather than the nuclear resign option could we gradually escalate to Def Con 1 ?
    1) no appraisal revalidation
    2) No CQC co-operation.
    3) No OOH work.
    Then if previous rungs in the ladder have had mass support-push the big red button.
    Yours sincerely Dr Strangelove.

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  • NHSE have produced a very nice glossy magazine - how much did that cost? the remedy is very simple for general practice. Relieve the bureaucratic and regulatory burden , simplify our pay structure and stop moving goal posts so we have time to provide proper care of patients which frankly is quite hard work and stressful in itself without all the other c..p!

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