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BMA asks GPs whether they would quit the NHS over contract changes

The BMA is surveying GPs on whether the proposed contract changes could make them leave the NHS, as it prepares to draw up its response to the Government’s official consultation ahead of a possible imposition.

The question is included in the BMA’s survey of members which was emailed out to GPs in England yesterday, which also asks if respondents would consider swapping a partnership role for a sessional position, moving abroad or taking early retirement.


The findings of the survey will inform the BMA’s submission to the Government’s consultation on the issue, which closes on 26 February.
Questions asked in the survey include: what actions GP practices may need to take in the face of these proposals, including decisions about staffing levels and the services they provide to patients; whether GPs will consider making changes to their personal circumstances, including leaving the NHS; and how these changes affect GPs’ views of the future of general practice.
The BMA has warned the Government that GPs are already struggling with a heavy workload and that the proposed changes will exacerbate the pressure on general practice. It has also said many of the proposed contract changes are unnecessary or unworkable.

Among the questions, the BMA asks what actions individual GPs expect to take. The options are: ‘I shall make changes to the amount of work I undertake’; ‘I shall seek a post as a sessional GP (locum or salaried) if currently a contractor’; or ‘I shall leave the NHS’.

It also asks GPs who said they would leave the NHS what they expect they will go on to do. It asks ‘if you leave the NHS will you: Seek work as a doctor in another country/seek work in a different career/or take retirement earlier than planned?’

GP chair Dr Laurence Buckman said: ‘The BMA wants to hear directly from GPs who will have to deal with the implications of these proposed changes on their practice and patients.’
‘Our research has shown that the average practice could lose £31,000 in funding and face substantial extra demands on workload at time when many are already struggling to cope with years of contracting practice budgets. It is important that we build up a clear picture of how these policies are going to affect the way GP practices are able to deliver services to their local communities.’
‘I would strongly urge all GPs to take a few minutes to fill in this survey and encourage their colleagues to do the same. The BMA has a number of online resources designed to give GPs the facts about the proposals, including a ready reckoner that helps give GPs an estimate of how their practice might be affected financially. We also will be holding a series of roadshows across the country where GPs can put their questions to the BMA about this important issue.’


The Scottish GPC has agreed on a separate, altered 2013/14 GP contract deal, while Welsh GPs have rejected a watered-down proposal from its Government. The Northern Irish Government is expecting to launch its consultation to impose terms later this month.

Readers' comments (13)

  • Let common sense prevail

    The BMA seem to suggest that the DH are carrying out a 'consultation exercise' relating to their decision to IMPOSE changes in the contract.
    Shouldn't the CONSULTATION occur first, thus making the IMPOSITION unnecessary?
    This really does confirm what we already new about government 'consultation exercises'.

    PS Dear Moderator, I have removed my own expletives to save you the trouble. xx

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  • Vinci Ho

    We are logically more interested in what BMA will do with the result of this survey rather than the result itself, Lawrence.
    CQC has identified 17 NHS hospitals dangerously understaffed . Can we say there is also danger of understaffing in general practice overall???

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  • What is the point?

    They will just say they cannot change the view of the Government. Lump it or leave.

    I'm taking early retirement!

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  • As much as I like UK I anticipated the way things were going last year. Too young to retire so decided to take the plunge and move overseas. In 6 months I've almost earned the same income as my annual GP Principal income in the UK, I do no out of hours, appointment times are 15 mins, no restrictions on referrals/prescribing. Only downside is less well developed clinical IT systems and no registered list system.

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  • Nhsfatcat

    Dear Anonymous of 15th Jan 9.10am

    You've summed up nicely what our government cannot see. GPs in this country have developed and embraced good clinical IT systems, run lists to offer personal service have developed a first rate primary care service, but are now pressured by taking away our best resourse- US. 10m/pt max, extended hours, restrictions of Rx, referring and having to tick boxes to earn money regardless of how a professional should conduct a consultation and mangement of a patient. Won't mention pathetic ploys to restrict income, pensions and a life!
    I wonder if as a profession we'd have failed to make a good service private companies would be sniffing about or the government would bail us out- G4S, the dome, car industry, banks...

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  • This latest matter really is developing into a farce with the latest changes going to be imposed anyway. If we all leave the NHS then we'll be blamed for all its past, present and future difficulties. If we stay as we are then we'll continue to get shafted. Catch 22!
    If we are going to be treated like a dog by the government then perhaps we should stop behaving like mans/governments best friend and somehow start to bite back! Everything we know and are part of in the NHS really has been well and truly FUBAR'd (as I've implied in a previous letter to Pulse)

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  • i agree with all the above entirely.but at the end of the day the people elected the government to represent them.we either like it or lump it.not a lot more you can the old saying still holds true.united we stand,divided we fall.

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  • We should not be afraid to walk out on NHS just because we may get blamed for collapse of NHS. Patient expectations are increasing and are more litigious and any system to contain costs increases risk of litigation more.
    We may walk out of NHS unless a HRG rate is agreed for consultations and lower the proposed cost to £15 a consultation or lower ( research suggest its £25 if they include QOF, premises and monitoring etc). This will make us seem to have an acceptable offer and government can`t go on to say we are greedy.
    Or just walk out ,dentists were labelled greedy but didn`t prevent them from increasing income with greatly reduced workload. We hardly get a good name in press nowadays.

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  • There does seem to be somewhat of a recruitment problem in general practice currently (speaking as a GP who is trying to recruit, to a clinically and financially viable and sound practice). That would suggest that, if we choose the option to remain in the NHS, there will be a vicious circle of more pain for less gain for those remaining diehard partners.

    Early retirement may be feasible perhaps for some from their mid-fifties onwards, if locum work is then embraced, but I would suggest may not be financially viable for many before that.

    I wonder if the BMA will have fully worked up costings etc for those doctors who wish to take the plunge and embrace private practice? I suspect if about 10% of NHS GPs were prepared to take the plunge, somewhat like the dentists were prepared to do , the proposition would be more likely to succeed.

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  • How do you get £15 per consultation? We get over half a million for 5000 patients at slightly over £108 per patient.. Our expenses as a small practice is high £ 66 - our profit is £ 42.00. Average consultation is almost 6 - so that before expenses £ 18 after expense £ 7.00. But paperwork is 50% so actually half of these figures [ £9 /3.50].
    If we leave the NHS, like Eire, we would not have a] the same expenses, b] the same consultations and c] the same paperwork.
    It is £50.00 to see a doctor and £ 100.00 for A+E. I do not want to see this as I believe in the NHS for patients, but we cannot continue like this either. When I open a consultation this avalanche of rubbish - Medication RV, smoking status, co morbidity forms, carer status,alcohol advice to state a few,. What about the patient?
    Only cowardice, I admit I am, of the great private unknown, keeps me. But I think we are better than £ 3.50.

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  • What the BMA have never done is draw up proposals for primary care to exit the NHS (not a strike - just leave).

    The BMA should publish a document of how the logistics could be arranged, for the profession to consider.

    Perhaps a pilot area first, were all primary care have unanimously opted out, then the PCO would be forced to contract with them all. A divided GMS / private contract PCO area would not provide enough solidarity within the profession.

    Of course this would have implications for pensions, VAT , staffing and practice finances (would now all be in the private sector), which should be adequately funded to make feasible, but at least we would be bringing back control of our work and maintaining professionalism.

    This is the only way forward to get out of the depressing hole we are in.

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  • £50 to see a private consultant on the mainland.??!! and the rest! which is where nhs users are being driven

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  • I am not sure what answer BMA expects from GPs in return to their question - would you quit your profession over contract changes? I am not sure what do they want us to answer. Not impressed by BMA's last year one strike. Not just on how they represented medical members (primary and secondary care), but also the work carried out on members behalf for fighting to save our pension

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