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'New deal' threatens existence of general practice, BMA declares

Jeremy Hunt’s new deal puts at risk patient safety and threatens the very existence of general practice in the UK, the representative body of the BMA has unanimously declared.

At this week’s Annual Representatives Meeting in Liverpool, representatives of every medical profession voiced their disappointment in Friday’s pledge to force seven-day working on general practice in exchange for 5,000 more GPs and support for struggling practices.

In an urgent ‘rider’ to a motion on political interference in the NHS, representatives urged the Government to look instead at rescuing the current GP service, addressing years of underinvestment.

They called on ministers to focus on investing in existing GP out of hours, as seven-day working pilots found routine care at weekends was ‘unpopular with patients’.

The original motion said that policies should be ‘made in the light of best evidence’ and when ‘evidenced to be in the best interests of the patients’.

However, the rider – proposed by Dr Amy Small, a GP in Lothian, Scotland – stated: ‘That this meeting is disappointed to note that the secretary of state’s announcement of a new deal for general practice fails these tests, putting at risk patient safety, continuity of care and the very existence of general practice.

‘This meeting insists that government first focus on rescuing the current service to allow safe and sustainable care for patients.’

Dr Small, who has written for Pulse explaining how she went part time after the pressures of general practice left her feeling burnt out and ‘drowning’ told the ARM she was ‘furious’ with the health secretary’s speech.

She said: ‘Mr Hunt’s promise of 5,000 more GPs to follow is hollow. It’ll take a decade to train them, and in the meantime he wants us to work 40% more hours?

‘The vast majority of our patients don’t even want to see a GP routinely on a Sunday. I worked in a surgery that was open seven days a week, and I sat around twiddling my thumbs as people had better things to do that day.’

Seconding the rider motion, fellow GP Dr Farah Jameel said her message to the Government was ‘simple’, saying: ‘Unless what you really want is a service made up of exhausted, burnt-out, hamster-wheel doctors running a piecemeal, haphazard sort of service, putting patients at risk.’

‘[Representatives], it is imperative we stand together as “one profession” and send out a unified statement: “We want a better deal for general practice and patients, focused on fully resourcing a quality 24/7 urgent GP service and improved daytime routine access that can provide for safe patient care day and night”.

‘Our house is falling down, and secretary of state for health, what you are proposing is building an extension to that house.’

BMA chair Dr Mark Porter launched the ARM with his own conference speech decrying the new deal and its focus on seven-day working at the expense of investment in core services and out of hours.

And an open letter from GPs calling on the profession and public to reject seven-day access without investment has accrued more than 2,000 signatures, as part of a growing ‘no deal’ backlash.

Motion in full

Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE NORTH EAST REGIONAL COUNCIL): That this meeting believes that politicians irresponsibly fuel unrealistic public expectations of healthcare services for their own political ends, and:-

i) deplores politicians’ persistent and zealous pursuit of political dogma and ideology at the expense of patient care and without due regard to the view of clinicians, patients and the public;

ii) welcomes the BMA council #NoMoreGames campaign asking all political parties to stop playing games with the NHS;

iii) urges the governments to ensure their health commitments are made in the light of best evidence;

iv) urges the governments to ensure any changes to healthcare and delivery are only made when this is evidenced to be in the best interest of patients.


That this meeting is disappointed to note that the Secretary of State’s announcement of a new deal for general practice fails these tests, putting at risk patient safety, continuity of care and the very existence of general practice. This meeting insists that government first focus on rescuing the current service to allow safe and sustainable care for patients.


Related images

  • Dr Farah Jameel

Readers' comments (36)

  • Many Gps wouldn't go on strike just as in the past. The media would be all over any negative patient experience. How about a half day strike? More GPs would take part.

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  • @anonymous GP partner 3:25pm

    As a younger ex partner aged 35 who left the uk a few years ago when the writing on the wall became visible I'd mention that the younger generation of GPs will probably never be able to accumulate and certainly enjoy ( we simply probably won't live long enough to see it) a good NHS pension. You've done well in our eyes and the folk on the ladder above you have probably done even better. I was also struggling to get into the property ladder in uk and had to buy an old semi and make do! I don't imagine many young 30 something's will see the kind of growth on their homes that will take them past £1m.

    I don't begrudge any of my older colleagues the success they have achieved because most of the worked hellish hours back when they were starting out.

    However shackled with a lack of opportunity in the uk, the equaliser for the younger generation now is emigration. That's the only way I can see they will be able to match or in some cases exceed what our senior peers have managed.

    Good luck to all practitioners though young newbies, mid career and those looking to retire shortly. It's clear the profession is divided beyond redemption and it's every guy for himself right now.

    I took the plunge across the pond and haven't regretted a moment of it and when they close doors for you back home, others open up for you elsewhere and what seems like a kick in the backside in the uk could actually end up becoming the gentle shove you need to get your life back on track again.

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  • look the Government is destroying traditional GP, but things change and this will just open up new opportunities for doctors to work privately. We just have to do this amongst ourselves rather than be swallowed up by the big health firms. It will be tempting to accept their offers but we must do it ourselves.
    Unfortunately patients with les money will suffer with a second rate service but weve been trying to warn people and they don't listen. All we get is their jealousy that we earn more than them (perhaps not per hour for some partners doing less well, even some on high benefits may earn more. 26k with no tax and loads of other stuff for free is a lot!). They will unfortunately understand the true cost of healthcare if this continues.

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  • We at least need to be united in refusing to operate routine weekend opening. Let that be run by Hunt's mythical physicians assistants if he wants it and leave the rest of us to practice properly. I wish those who have fallen for the short term pilots would realise the likely long term outcome.

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  • @3.25
    I am that older GP.
    And you are spot on.
    Plenty of older GPs than me didn't get stuffed by the pension scheme like I have, and if I were your age I would definitely emigrate.
    You do what you can with what you have.

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  • If I was Jeremy hunt I would be laughing my head off! He knows there is nothing the BMA are going to do about it except whinge and then accept it and try to convince therest of us that we should do it for the sake of our patients. 50% will just do it and make the rest of us look greedy or unwilling to accept change. Strike action will never happen as many will never strike. Its game over folks - I blame the BMA and rcgp for doing practical to help those GPS that want out but for continuing to prop up the flawed current NHS model - and it is flawed.

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  • I left the UK in 2002 and haven't looked back. I recently looked at returning to find I would be treated as if I never qualified and have to 'be assessed to see if I am fit to join the NHS'. That could take up to 6 months on NO PAY. I have been in full time practice since I left and can prove it. I relicence every year. Stuff that, I won't be back.

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  • Peter Swinyard for the Family Doctor Association view on the present "New Deal". If that deal were in a poker game, a certain player would be accused of cheating and misrepresentation.
    When the ship is holed below the waterline, a coat of gloss paint won't do.

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  • Please can we rally everyone to the cause so to speak all staff whether the cleaner, admin, nurse or GP are affected by the current inuendo of further change for general practice. All the staff within a practice play a vital role. we should all send a clear message not to do the current prooposals and formulate a way of working we can make happen!

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  • Close lists once it gets over 2500 per wte ie 15000 consultations per GP per year.

    Only when thousands are wandering the streets trying to get on a GP list will Hunt take any notice.

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