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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)

  • In addition to the above just posted...part of the problem is many of the folk who were willing to leave have already left or gone salaried. Those who are left are the ones who don't want to or can't. Almost by definition things have got so bad only the desperate/stoics/??masocists are left behind and I don't believe these are the folk most willing to do what's needed if this approach is to work...a few years ago perhaps when some of those now talking from the side lines were still partners - mass resignation IS a reality, it's already underway by stealth but asking those left behind to take the step they haven't thus far been prepared to do is a risky proposition likely to fail.

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  • "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. "

    This is both a fantasy and a myth. The UK has a fairly average (even below OECD average) number of doctor consultations per head as compared to other developed nations who do have a co-payment system. With co-payments, you'll be expected to actually offer a service as the patient is paying for it and they'll want their money's worth. If you really think people with colds don't go to the doctor when there's a co-payment system - you need to get out more.

    Also, every time GPs blame "patient demand" they should take a step back and consider just how many of these unnecessary appointments have been instituted by the GPs themselves whether it is for time-wasting "Health checks" or duplicating tests (that have been done in secondary care already) just so they can get the QOF points and the QOF money.

    More doctors (as there are in other countries) would solve some of the issues as would less focus on points and income.

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  • the problem isn't demand its supply. We overwork ourselves too easily to accommodate patients. Limit appointments to 30 per day 25% of which are take a ticket style walk in for urgents(1st come first served rest to A+E) the other 75% booked for chronic matters and it would self regulate.
    We need to stop fillin gth doctor gap by doing the work of 3 40 50 100 patients a day is crazy. Just stop it. We need a contract that doesn't force us to register unlimited patients and see unlimited numbers in a day. The gov will have to sort it out when patients complain by enticing overseas doctors or more of our own by incentivizing.

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  • no other professional just sees unlimited numbers of clients by squeezing more in at the expense of quality. we allowed this. very few are actually urgent and A+E does a very good job with those.

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  • The GP system requires a certain amount of money to run effectively and adequately reward doctors. The government well knows this and is not prepared to provide the necessary funding.

    It is, however, quite prepared to allow rich companies such as Boots, Vodafone, Starbucks, etc., to avoid tax on UK profits by claiming they are registered abroad. This revenue loss is estimated to be well above £30 billion annually.

    The financial and workload crisis we face in general practice, the ambulance service and hospitals is purely of the government's making.

    Regrettably, the media, once the "last resort" of the common man to obtain justice, nearly always supports the government line, and is particularly opposed to professional bodies and unions.

    When was the last time you saw the TUC general secretary quoted in the papers or on the TV?

    I see no solution to the GP crisis, the hospital crisis, etc., until such time as this government is out of office.

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    1) I agree with you that patient will expect more when they are paying. but by the same token they will also start listening and take doctors advice seriously.
    2) Because patients will have to pay, all minor coughs and colds seeking advice will be reduced, yet there will be some worried well who will still come.
    3) GP don't enjoy doing health checks and asking pt to book appointment for blood checks for fufilling QOF but we have to do it sometimes otherwise practice income will be further reduced which will push many practices under the water. Many efficient practices do this by telephoning pts or postings blood forms.

    I am not sure what experience you have of general practice but can tell you that i don't need to get out more as I made these statements after working in 4 different countries (India, Brazil , France & England) so can say i have seen fair bit of healthcare across different continents.

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  • 1) no appraisal revalidation.
    2) no CQC inspection (don't pay for them or let them in )
    3) no OOH.
    4) resign locum emigrate.

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  • They've finally grown a pair!

    Still too late for any significant change. DoH restructured the CQC and NHSE to work against the current system 5 years ago !

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  • I would suggest that mass resignation of all GPs currently involved with both CCGs and LCGs would send a message. This would have no impact on patient care, would divorce us from being complicit in the governments plans for the NHS and would constitutionally make these organisations redundant. This would be a political measure only causing an administrative headache and places the responsibility for the NHS back in the hands of the government. For those who would claim that this gives us no voice in organising services locally , it is my experience that all new ventures ,projects etc are disseminated down to local level from on high and there is little to be done other than rubber stamp as they are all a fait accompl anyway.

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  • I is shame for an MP pay increase is one and for Dr wether nhs or GP is an other rule.

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