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A faulty production line

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)

  • Dear Dr strangelove, ---YEE-HAH !

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  • Well done - get on and vote . I've left and it's the best thing I've ever done. Gp crisis is real and getting worse

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  • There is of course the third dimension - Private Health Insurance for ALL - Look how providing a Workplace Pension has become commonplace in recent times, why wouldn't paying £10 a month towards seeing a doctor, based on an individuals income level become commonplace with protections for Universal Credit recipients? It's a direction of travel that I see happening. It might not be a bad thing either, it would stop all this unnecessary visits to A+E and wasted medical practitioner time, it might even see a massive hike in GP incomes - the NHS is unsustainable in its present form - AND WE ALL KNOW IT - So don't be too quick to start being a member of the Sheep Flock - THINK - Good GPs could become scarce - premium incomes could well come out of the present NHS re-organisations - I certainly won't be playing any trade union games!!!

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  • What will the government do with our resignations?
    - hand our practices to local hospital trusts and management companies to run
    - import GPs from Europe and S Asia.
    They'll be gearing up for this now.
    In three months from now their plans will be well ahead.

    What other sanctions do we have, that will not incur loss of patients' sympathies, nor put patients in danger, nor put us at risk of misconduct claims?

    - resignations from CCGs - Probably ineffective as those on CCG committees have more to gain by compliance with government policy.

    - mass resignation from referral management schemes. Worth polling on this one.

    - mass refusal to pay GMC subscriptions? - difficult for BMA to implement - perhaps the money could be sent to BMA to transfer to GMC when it thinks appropriate.

    - mass refusal to pay CQC fees? - as above.

    - mass refusal to make referrals from one consultant to another. - BMA to ask for agreement to this policy.

    - mass refusal to prescribe medicines when effects/side effects are monitored by others - eg warfarin, methotrexate. BMA to ask for agreement for this policy.

    - Safety first policy - investigation and referral on minimal pretext. non-compliance with hospital efforts to offload follow-up to GP. BMA to ask for agreement for this policy.

    - Use of trademarked medicines on minimal pretext. Ineffective as government will instruct pharmacists to do generic substitutions.

    Let's keep thinking.

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  • The idea from the anonymous doctor of mass non-compliance with appraisal and revalidation in its current form was good too - but it won't have HMG quaking.

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  • -mass refusal to do death cert and crem forms. worked in Auz 10 y ago.
    - non payment of CQC is my favorite. they are useless and irrelevant, and can continue out of their own good will (doubt they have any)
    - mass refusal to do any work for one week only- will have massive repercussions making final effect monumental. will bring any government down whatever patients sympathies are.

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  • Common just ditch the country comrades. You are not respected in UK and never will be!

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  • bottom line is we need to think ahead and look at what our options are if we walk out and start developing alternative models of independent healthcare.

    agree a first step should be non-compliance with cqc, qof, unpaid work, re-validation etc

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  • Were not respected in the UK, patients and NHSE bully us to do their bidding through verbal abuse complains GMC and forcing unsafe rates of consultation.
    Not sure this will ever change.
    rather than all out strike stop the admin CQC stuff as above and just limit to 30 patient contacts per day citing safety concerns to see more - permenantly.

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  • Vinci Ho

    First of all one should remember :-Doing the 'right' thing is not the same as doing the righteous thing in the right time of history at the right place .
    And one should not predict or wish to predict the so called outcome(s).After all these years ,NHS with GP as a gatekeeper is a deterministic , dynamic system which is fully determined by initial conditions, with no random elements involved. But small changes in these initial conditions can lead to far-reaching but unpredictable outcomes . Remember what do we call these effects in Chaos Theory?
    Indeed , it is exactly the unpredictability one should be playing for in ,an once in a life time ,extraordinary space/time right where we are.
    A non-cooperation campaign should consist of a series of action. This ballot is only one of them. People already mentioned no OOH , absolute refusal to pay CQC fee, my naive advocation of walkout of all GP commissioners etc . It is not about being right or wrong . Rather it is all about creating wave after wave of unpredictabilities and uncertainties
    matching up with other colleagues' actions in NHS on this bunch of politicians.Yes, it is a gamble ,some people have clandestine agenda and unity is questionable . But the war is already lost when one has started to calculate concerns.
    GPC will have to explain and justify to the public and media why certain action is to be taken but more importantly , it should concentrate on how to create this tsunami of unpredictably/uncertainty on this government . The fact the PM had to concede to back an amendment to TTIP for protection of NHS , demonstrates certain 'outcome' will only happen in certain time under certain 'initial conditions'........

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