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CAMHS won't see you now

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)

  • Are these the same 'Strength of Feeling' 'Grassrots' who supported Dr Andrew Lansleys' (Member of Parliament) NHS Reforms - ANYONE REMEMBER HIM? My point being that doctors are better at getting on with what they're trained to do (at great expense and privilege to the nation) and stop whinging - you're still better paid than a married school cleaner struggling to make ends meet on £7 an hour, less 15% stoppages; tax/N.I. Contributions/pension contributions) (PROSPECTIVE!!!) YOU've never had it so good and whilst the rest of the working population are having to accept less you're all putting a gun to your patients heads just because your £65 an hour means a bit more work!!!

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  • It is not about money this is about resources. Partnerships are under ever greater pressures as payments are arbitrarily altered to quarterly from monthly or sometimes omitted altogether, finding partners who are work limited not time limited is ever harder, part time GPs who are in the main salaried are in a buyers market, demand led services ever escalate while bodies on the ground diminish or suffer increasing levels of stress, resources paid to practices are altered or ceased without discussion, hurdles to cross to achieve same income rise or change. In short doing the job full time is a huge task that dispirits, exhausts and infuriates and robs one of a sense of value and worth. Whatever you do it is not enough. It is broken. Earnings have dropped, pensions have been damaged and taxation rises. At no point has any government official considered they might just be shooting the hen that lays the golden egg. For my sanity I am out. Many friends and colleagues are not. Please take action together now. It may not be too late.

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  • 14.08 You are misinformed. The health and Social Care Act 2012 was incredibly unpopular with medics and has paved the way for unwanted NHS privatization. Unsurprisingly doctors are paid more than cleaners although many of us have done low paid work in our student days and know it is hard. No-one is blackmailing patients. The reality is that practices all over the country cannot recruit and cannot meet their expenses. This is leaving large areas of the country like Brighton, Swindon, Essex, Somerset , Leicester and the Northeast with very poor access to, or even worse no GPs. The market would seem to suggest that we have in fact never had it so bad!

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  • I am astonished at some of the opinions expressed here and the insults aimed from anonymous contributors to random others and, bizarrely, to items of clothing. I wear cardigans occasionally and am a 'soft fluffy smiley woman' but I am also tough and able to think and speak out for myself. I have pushed forward boundaries during my career. Let's have fewer silly, petty insults, fewer exhortations to 'ditch the country' and use our brains instead.

    I doubt the threat of mass resignation will work at the moment. Mr Hunt did not blink first when faced with all out strikes from the JDs and he will be sure that even if we threaten resignation, most GPs would never actually carry it out - there is too much to lose personally.

    I also feel it would be a dreadful thing to refuse to sign death certificates and crem forms. Making the bereaved suffer further at their most vulnerable time is really not good. I have been in that situation due to particular circumstances and that was hard enough - utter despair. If the delay had been due to the trusted professional wilfully refusing because of their industrial dispute I would have also felt murderous - not towards the government, but towards the GP.

    Can we also stop blaming the patients? We're overstretched because there are too few of us - simple. There have always been patients presenting inappropriately and always will be. (But the beauty of GP is to develop the long term trusting relationship which makes consults more efficient and less challenging. Or is that me being too soft and fluffy?)

    So now I'm in a corner because I cannot at the moment suggest the perfect alternative action which has no downside. All I can say is that I know what the profession shouldn't do and that is to cut off it's own nose to spite it's weary frustrated face.

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  • Dear Anonymous GP Partner at 2.54 PM. None of us have come to this decision of resignation easily. Lot of us will loose financially as well in the initial period. But there is no other choice.
    Your reasoning of we are over stretched because there are only few of us is flawed. Moment there is co -payment system or patient start paying for cosultations partly this overstretching will disappear overnight. trust me everybody will be able to get GP appointment in 24-48 hrs.
    I again say that patients will realise how good current NHS was only once it disappears.

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  • We can make things easier for ourselves by ditching CQC and revalidation . This will have no effect on patients because it has no value for patients and is a waste of our time . A boycott of OOH work is more questionable but would undoubtably be effective . The problem is these actions need a concerted effort . If were not prepared to act together were screwed anyway and might as well wait for the axe .

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  • I have been a GP for 25 years and this is the worst time I have ever seen

    we are in a poor area where it is difficult to recruit

    this has resulted in me working single handed not through choice with a list size for at least 2 GPs

    I have to use locums and this is expensive and also it is very difficult to get holidays

    we talk to patients about quality of life and ensuring they have good work life balance but I am afraid we do not have that and have to do something

    The workload is unsustainable

    The days are long and exhausting and I can no longer get the days work done in a day and I consider myself to be efficient

    I constantly see colleagues slightly older than myself retiring earlier and we are losing their wisdom and expertise

    we are under constant pressure to be as close to perfect as possible but the system isn't safe

    we constantly have work dumped on us from secondary care

    please for GP to review patient

    GP to do renal bloods 1 week after discharge and the discharge letter arrives 2 weeks after discharge
    etc. etc.

    I always felt I would never take industrial action but I now think we have reached a stage where this is the only action which may make the politicians take notice

    I also think talking to my patients we would have the publics support as on the whole they can see through the politicians false undeliverable promises and also I think they would be largely supportive as they can see the pressure the system is under if we don't do something there will be no system to look after us when we actually need it

    so I think we have to stop talking now and take action

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  • Took Early Retirement

    Felix M is a troll.

    Only a fool would compare a professional, with A levels, degree, postgrad diploma, responsibilities and skills with an unskilled cleaner.

    Now, Dear Ivan, "Resignation will play straight into the Tory Privateers....which is may be what you want, but the public wont accept it."

    There ARE no privateer bogeymen waiting to take over and in any case, they don't have the staff. Remember Hinchingbrooke and Circle? We don't see Circle around much and they pulled the plug on their Primary Care wing years ago.

    As to the public not accepting it, what choice will they have? In Australia, if you are a public (bulk billing) patient, you have to go to a public practice, not a private one. What, I repeat, will the public do? Kidnap doctors and hold them to ransom till they sign a MED3?????

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  • I love this job. It's just a pity it's caked in politician shit.

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  • What good is an undated resignation? It is a threat to do something we won't do, anyone can see that. The government will call our bluff and spin and we will cave. Something defiantly does need to be done but as a salaried GP in a struggling practice with 5 partners I seriously can't imagine any of them resigning - even if they can't see it themselves they are all burned out and look miserable and every day I watch them struggling and complaining but I don't see them resigning - they have too much invested. As a salaried GP I could resign, sure, just like the JDs basically threatened, but partners aren't salaried, they own a business, they can't just walk away, not in sufficient numbers to make this a serious threat. Work to rule, refuse extended hours, etc etc or something else. I'd vote to resign myself but I can't see this working. I don't know what exactly we could do but threatening something you aren't 100% sure you'll do is a weak starting point...couldn't we come up with something more probable?

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