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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)

  • I totally agree with Dr Glasspool. Thank God I got out when I did. (2011). I know , from my 32 in practice, through Mrs. Thacher, Tony Blair, and David Cameron, that GPs will never resign. Their's is a " fair accomplish". So, no point in making threats.
    Also, GPs should consider " do we want to be like Greece"? So, forego a little, to maintain the status quo.
    Retired GP.

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  • Bit frustrating really. We threatened mass resignations 6 months ago if we didn't get a rescue package. 6 months on we're still full of hot air and finding excuses to delay our threat. We needed action 6 months ago. This is another frustrating delay. The government know we will never do this. Which is why we have no hope and general practice is doomed. I'm tired of all talk not action

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  • Dr Andrew Green is right, the ballot will expose the fact that most GPS will not take action or resign. Partners dare not risk their homes and savings. Most new GPs are soft fluffy smiley women, not the fighting type.

    You have now called your own bluff, you will expose just how weak you are, and increase the rate you are trampled on. Well done! :(

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  • A bit of realism is required.
    Any increase in funding going to "primary care" will be siphoned off by the black holes aka acute trusts that are in deficit. There is NO MONIES coming to general practice.
    The only argument that will wash with the public is safety. ....but do they care.
    No it's a free service that is abused by everyone not just patients. More stuff is going to be dumped our way with no attached resources.
    I am getting out and changing career aged 43

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  • I see my children awake only 3 days out of 7, I drive a £8,000 car, I live in a terraced house next door to families who don't work and scream daily, I'm overwhelmed in debt accumulated in university education, I am abused daily by patients, get snotty comments from hospital doctors, midwives, health visitors, cpn's. I don't even get a lunch or coffee break.
    I'm sick of waiting for things to improve. I'm not the only one.
    Nobody respects us, I have a worse lifestyle than if I stayed home and developed a drug habit.
    Resignation, bankruptcy, redundancy payments, it can't be worse than the miserable existence I live now. I cry daily I ended up being a GP and am ashamed to say what I do for a living when asked.
    FFS stop messing around BMA get us a decent deal or get us out of this dreadful contract.

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  • 9:28am - don't count on the BMA to do anything. When your life is shit you have to help yourself. Ditch the country!

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  • Just get out of this disaster. The politicians abuse the nhs and everyone working in it.
    Time to leave and i have decided to do so at 41.

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    worth reading

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  • I'm with Dr Strangelove on this one.

    The problem for many of us is that we own our premises and have mortgages to pay and we are simply not going to put in undated resignation letters - the govt know we wouldn't follow it through.

    However, not co-operating with CQC would be just fine, so long as everyone did it (but again, mortgages to pay).

    Refusal to do OOH work would bring the citadel crashing down PDQ, and overwhelm A+E departments who are already overwhelmed, but it seems like the govt only take notice of hospitals missing targets because that's what gets the press involved.

    Revalidation/appraisal refusal would also be just fine but only if everyone did it - and the problem with this and CQC non-co-operation would be that the first few risk losing their livelihoods over it.

    I do think there is a strong case to be made for not doing OOH work, and it would end up in private companies being asked to step in, who would have to pay a market rate and even then wouldn't be able to fill the shifts.

    Ultimately though, we can't do anything that would directly harm our patients, and sadly we can't afford to inconvenience them too much, or they will come banging on our doors and make all our staff so miserable they will leave and then the whole lot falls apart.

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  • at least everyone agrees that something should be done ?

    the next step is deciding what should be done i.e. what are the options ;

    1. do nothing - no longer not acceptable
    2. work to contract
    3. disengagement with CQC, revalidation and unpaid work
    4. mass walk out
    5. others - add to list

    with option 4 we need to know what will happen if we walk out - i.e. can we just transfer to be private GPs ?

    this is a bit like brexit or GPexit !

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