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GPs buried under trusts' workload dump

GPs approve 'nuclear deterrent' of mass resignation at emergency conference

GP leaders have moved a step closer to a potential mass resignation should the Government fail to respond to ongoing pressures facing general practice.

At today’s Special LMC Conference, delegates 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’.

But to the dismay of some GPs, the motion was watered down ahead of the debate, having originally suggested the GPC go ahead and request undated resignations at the six-month deadline, rather than just canvassing.

The motion, in three parts, called on the GPC to identify what other actions GPs could undertake without breaching their contracts, and to ballot GPs on what services practices could stop providing in order to reduce workload and ensure ‘safe and sustainable care’ for patients.

A Pulse survey of more that 900 GPs carried out at the end of last year revealed that half (49%) of GPs support mass resignation from the NHS in protest at the current state of general practice.

Today’s special conference  – the first one called since 2003 – looked specifically at ‘what actions are needed to ensure GPs can deliver a safe and sustainable service’ amid concerns over workforce, workload and the defunding of general practice.

The Department of Health has promised a package of ’substantial funding and support’ as part of a big announcement due next month. Earlier this week, NHS England’s chief executive Simon Stevens said this ‘wide-ranging’ package would include ’measures on workforce, workload and service redesign’.

Dr Katie Bramall-Stainer, a GP in Hertfordhsire, told delegates: ’[This motion] allows time to deploy our nuclear deterrent without actually letting it off. This is the headline to launch the campaign. Hold your noses and vote yes. Send a lightning bolt to NHS England.

’It is not safe, and it is not fair – and it is not just for juniors – because this is a state of emergency. So, conference, if not now, when?’

GPC chair Dr Chaand Nagpaul said he was ‘very happy’ to support the motion because GPs have to do ‘everything we can’ to support general practice.

Dr Anthony O’Brien from Devon LMC said: ‘There is no point canvassing unless you think it is likely you are going to get a consensus. I think this is highly unlikely but let’s suspend our disbelief for a moment, let’s explore it. Mass GP action would need mass GP support.

’Mass support only comes with good, motivating publicity, so if the BMA and GPC truly believe they have a polished public relations machine that could convince GPs to involve themselves in mass action… in the future, well that would be fantastic.

’But that begs the question, what are these PR wizards doing at the moment? They are certainly not using their amazing skills very successfully to get the plight of general practice in newspapers.’

The motion in full

That conference instructs GPC that should negotiations with government for a rescue package for general practice not be concluded successfully within 6 months of the end of this conference:

(i) actions that GPs can undertake without breaching their contracts must be identified to the profession

(ii) a ballot of GPs should be considered regarding what work/services must cease to reduce the workload to ensure safe and sustainable care for patients

(iii) the GPC should canvass GPs on their willingness to to submit undated resignations

Source: BMA

 

Readers' comments (78)

  • If GP contract holders truly believe that their services are unsafe then they have a moral, ethical and legal obligation to cease providing them don't they?
    And let me preempt the inevitable "but what is the alternative?" It really isn't for providers to find solutions for commissioners.
    Ask yourself - Would you fly with an airline that openly declared that its operations were unsafe? Or an airline that flew planes with unqualified pilots?

    If the cardigans care so much about NHS service users they should cease trading and stop exposing them to danger!

    Ditch the contract comrades!

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  • @mark essop

    The cardigans don't care mate. There job is to keep the gravy train running as long as possible so that their future is secure off the backs of flogging younger doctors .

    If you're young, relatively smart and able you will be making your exit plans.

    If you're thinking that those who came before you have your interests at heart I'm afraid you're going to have to keep waiting.

    Ditch the contract doesn't go far enough...


    Ditch the country comrades!!!

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  • @ Mark Essop,

    Cover blown lol

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  • it's about timing.

    majority of leaders 50 yrs and have pension secured. their remit is to keep system going until THEY exit. the younger generation are expendable.

    they want to move to federated / corporate general practice asap before the next generation get their hands on power.

    i'm guessing the younger generation have nothing to lose from ditching the contract and would leave it to form something else eg like our dental colleagues. unfortunately they will never be given a chance.

    if there are any

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  • Hitler was holding on to power until the last minute ( in his mind that is ). The over 50s cardigans suffer from the same syndrome- delusional disorder with aside of megalomania and self interest. Bon appetitto.

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  • Those carping in this forum that it's just words, please reflect that politics is largely just words but if as a profession we have any desire to influence government policy, political support is exactly what we will need!

    Well done Dr Nagpaul and let's hope you produce some headlines outside the medical press.

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  • RIP general practice.The cavalry is coming over the hill but wait, what is it, its just DR Nagpaul banging a pair of coconut shells together.We're doomed we're all doomed Captain Nagpaul.I afraid we are.Down we go.

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  • General practice dead. LMC meeting was to confirm death.

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  • JH will issue the death certificate next month.

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  • Final nail in the coffin, yeap.

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  • Better than nothing I suppose.

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  • Who are they kidding. This watered down motion for 'undated' resignations means nothing. Politicians know GPs have no balls and today the LMC have proved it. What's needed is a definite resignations on a specified date.

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  • "(49%) of GPs support mass resignation" - thats nowhere near enough to have any effect.
    Chaand didnt look very optimistic at the special conference, that he would have sufficient majority support and the unity that would be required to enable the leverage in GPC negotiations with HMG

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  • Took Early Retirement

    The idea of teams ready to don a parachute and go to help practices is risible. Any volunteers? Heaven knows what one's MPS/MDU fees would be.

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  • Well done for not voting with your feet. Level-headed thinking and foresight shown. The NHS is in deep trouble and only a long game approach will get us out of it.

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  • Give credit where credits due they passed the motion!

    I didn't think it would happen so pleasantly surprised but what will it mean in real life?!!

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  • Nuclear? What like submarines with no missiles in them? Ooooooh scary! They are probably holding a Cobra meeting right now.

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  • Nhsfatcat

    If the passion shown by the speakers on motion 20 can be promoted and seen by ALL GPs then that motion can be strengthened for the LMC conference. Can pulse get hold of the videos?
    Yes it was watered down, yes that was wrong but you have to go to the gym to toughen up for a boxing match and the LMCs have given the GPC the chance to train.
    I think the LMC proposals to the annual meeting will be stronger in directing the GPC.
    I heard 'Tear off the cardies' from one speaker. Most of those in the hall have, the rest of the GPs need to follow. The feeling from the top is it's do or die.

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  • There are a lot of Ivans out there who would love to undermine the efforts of grassroots GPs so this is going to be a difficult battle.

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  • I can't see who would pay my salaried guys and notional rent?
    Where can you get so much cash for a pretty cushy job for life

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  • My Friends this is your last chance to show Mr Hunt you mean it.

    Walk the talk and be an example to the junior doctors.

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  • Address the reasons for failing practice rather than send in teams. GPC keeps making speeches, sending posters like Your GP cares. They never do anything. Anybody can make speeches. I am certain I could speak for hours, but like me,GPC does nothing

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  • The mood of conference waas overwhelmingly that the same-old-same-old was getting us nowhere and we are now in such crisis that we must take action. The Government isnt listening. Whatever new package they announce will just be sticking plaster, leaving us limping on. They do this every time and it just gets worse. We need to do something that shows we mean business. They are killing us anyway. Slow death or use the only weapon we have with any real teeth- the threat of resignation? We need to save General Practice for the young GPs coming after us and stop giving way to fear and the 'what ifs'. So Yes- if not now, when?!!

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  • Took Early Retirement

    Well, all I can say is that the young lady in the picture has a pretty impressive filling in one of her molars.

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  • @glasspool - what the heck dies that have to do with anything? We're taking mass resignations and you're more concerned with one delegate's dental care?

    Stick to the point, fool.

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  • Exactly 8.14 unless 100% of gps threatened resignation it will not work. We all have mortgages etc. I would say strikes ... Regular and often with work to rule the days after to limit a double clinic load 24 -72 hours on, so the public begin to learn what we provide day in day out . Empty threats get us no where and let's face it 50% of gps are either soft or worry about loosing their income so until the other 50% see their earnings fall despite all the extras they have taken on to stay afloat they will be too scared to protest . Jeremy ..unt knows this perfectly well. No point in empty gestures

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  • I was against this motion. I did not believe we could get sufficient support for it to be workable.
    I listened to the speakers, time and again thy said we have to do something, anything to save General Practice and thus the NHS.
    What finally changed my mind was one of the Junior doctors negotiators. They were told that JDs would never strike, they pushed ahead anyway and on a 76 % turnout got 99% agreement to strike.
    If we can do even half as well then we have a chance to force change.
    We, the witterers of pulse, need to do our bit to encourage our colleagues to be ready to stand up and be counted

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  • @11:30pm

    Behave yourself! Show some respect. Dr glasspool is an institution!!

    He's an guys who's walked the walked and Walked away. If the GPC was like him they would not have threatened mass resignation, they would have resigned already

    That's the point!

    Ignore this ingrate dr glasspool and keep posting!! You're a breath of fresh air compared to some of your cardigan wearing cohort!

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  • Until we dispense with our outdated, impossible to deliver, bottomless contract we will always be in crisis. Deal with the fundamental problem Dr Chaand and the rest will follow.

    Ditch the contract comrades!

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  • Keep it up JG - nothing wrong with having a sense of humour. Aren't clowns supposed to make us laugh?

    That picture is begging for a caption competition. BTW, look up and compare it to the Edvard Munch in right hand column. Spot the difference?

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  • I love working hard in general practice now, I'm paid for each patient contact, and can top up this income with fees from the patients (who can afford it) too. It's probably more like the uk dental system than the NHS. I would never return to the uk until I could be properly rewarded for my hard work - but that's never going to happen, so anyone you enough to move should ditch the contract and ditch the country...

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  • Someone had to link to this didn't they?

    https://www.youtube.com/watch?v=YawagQ6lLrA

    Ditch the contract comrades!

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  • Vinci Ho

    You see.
    (1)The whole non-cooperation campaign(which should consists of a lot more than just 'a nuclear deterrent' )needs to start at somewhere . As I said , other 'activities' need to be debated on.
    (2) The hardest part in any form of civil disobedience is how one can awaken supporters to join. Quite frankly , most of my partners in the practice did not know about this emergency conference yesterday . Yes, some colleagues have already given up their membership of BMA ( understanable) .
    (3) Younger people are more easily blood-boiled and mobilisation hence is faster. The older we are , more 'sceptical' we are and more 'baggages' we are carrying .

    You have to 'believe' before you 'succeed' (sorry, my philosophical cr*p again)and we clearly need missles on top of a nuclear bomb......

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  • Una Coales. Retired NHS GP.

    Jeremy Hunt 1 GPs 0. Who got to the BMA? Who is responsible for watering down the motion on mass resignation in the 11th hour? Voting to canvass GPs on mass resignation in 6 months time is akin to taking a survery, a poll? It has no legal clout like a proper vote, ballot on mass resignation which can then be implemented with a fixed date. Sad day for traditional general practice.

    Yesterday I sat next to a billionaire at a free Lifestyle Business Convention in London listening to young multimillionaires share their pearls of wisdom to reach financial freedom. The billionaire asked me what I did. When I mentioned I was a doctor, he explained that we were in the lowest class in society. I was both shocked and humiliated. But what could I say next to a Vietnamese Brit who boasted he had bought a building in Surrey Quays with a Saudi Prince to add to his property portfolio.

    And today I read Pamela Wible's FB with premed, med students and residents share that they are at breaking point (cycle of abuse, overworked, never ending rows of night shifts, no occu health, huge debt, trapped).

    Why does moral wealth not equate to financial wealth?

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  • Full commercialisation of general practice, handing the sector to the acutes in the new STP's ... yep, mass resignation will really help

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  • Who are these GPs???
    They certainly don't speak for me. Or by the look of it the majority of GPs.

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  • 30th January 08.14.

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  • 30th January 08.14
    I hope that your comments were tongue in cheek.
    Under those circumstances they would be ironic but if not then you are a dope

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  • l earn £200k and have no intention of resigning. These whiners should make their practices more efficient , possibly federate. We are mollycoddled with LES / DES money, pay for fluvacs , notional rent at a very high level etc. If we keep on moaning we will be replaced by pharmacists and nurses - surely what Hunt wants Do not follow like lemmings

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  • nonymous | Sessional/Locum GP31 Jan 2016 6:55am

    If having a sense of humour means mocking someone's appearance when they are making a speech on such a critical issue, then frankly this is the wrong place for it. Fool stick to the pub.

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  • I see that the privileged middle-class know-it-alls are at it again denigrating GPs efforts in the face of perennial underfunding. See Sarah Baxter's article in the Sunday Times today.

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  • @|Anonymous | GP Partner|31 Jan 2016 9:27am
    'l earn £200k and have no intention of resigning'

    Yeah right, and pigs do fly! Wishful thinking should stay in your head mate.

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  • (Good morning to the Daily Mail reporter at 9.30. Keep up the good work.)
    Mass resignations etc are a red herring. General practice simply has very little reserve and it will require only a percentage of GP’s to leave before the whole thing will simply implode. The near retirement GP demographic, coupled with rising indemnity fees, government disincentives such as the removal of seniority and changes to pensions will ensure collapse within the next five years (and that is optimistic). In “nuclear” terms it will be all about where you place yourself when the thing goes off.

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  • I was at the conference and I am proud to be part of a group which has voted this in. Yes- it was watered down and I'm not sure why. Yes- the ballot and our negotiations with the government should happen simultaneously and not in 6 months. But 6 months will buy us time to campaign and win hearts and minds.

    I agree 100% with my fellow graduate Simon Ruffle. The ones in that conference room had already stripped off their cardigans. Our main aim now should be to encourage unity and have a mass burning session of them.

    Please spread the word. Join Facebook and Twitter. Join General Practice Survival group who are campaigning for these contract changes.

    If not now, then when?

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  • Will this conference make headline news? Possibly. At least there was a strong-ish statement, if not a threat. Only a threat to have more talks, but talks within the profession is what we need right now. We are far from united on this issue. And when the day to cast a ballot paper comes, heads will cool and usual day to day fears and insecurities will convince even the most militant folks to vote for the status quo, unless there is a viable alternative. People who have families and mortgages to worry about will not resign unless they have a plan B. Government know this, so for the moment they will see no reason to change their course. All this conference has achieved was a statement of concern and frustration. Now to make our masters really listen and become even slightly bothered GPC and BMA must come up with that plan B. We can't be making empty threats.
    I would personally be in favor of ditching the contract, scrapping Carr-Hill formula and replacing it with payment per activity agreement. That will get our overlord's undivided attention very quickly.

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  • It is disgusting and clearly indicative of media prejudice, that this is mentioned nowhere on the bbc news website or app.

    My faith in the bbc as impartial or balanced is completely crushed.

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  • Can you reduce your service without contravening your contract - this is not a strike its handing back your contract - are you liable for your employed staff's redundancy - are you liable for your borrowings on your practice premises secured on your bankers assumptions that partnerships are long lasting and secure -

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  • LMC emergency conference - & outcome - not mentioned on BBC Radio 4 news at all.
    Bad omen?

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  • I just saw the opening to the conference where they were arguing about whether they would follow the agenda or not.

    Probably best the mainstream media did not report on it as we look like a complete idiots.

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  • I had the dubious pleasure of attending the LMC conference yesterday. The GPC are not on the side of General Practitioner nor patients. They are covertly backing the Gov't destruction of the NHS and betrayal of the public interest.
    The conference opened with an announcement that BMA Law advise that any industrial action is unlawful. We need a new GPC and new legal advice. With the current complicit shower we are doomed.
    www.selloff.org.uk

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