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Comrades, it’s time to play dirty

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The Extraordinary LMCs Conference. I am still reflecting on how extraordinary it was.

Extraordinary to be surrounded by otherwise normal-looking GPs waving coloured papers, heckling and muttering.

Extraordinary how breaches of etiquette provoked disapproving stares at first-timers, such as myself. Extraordinary to see 300 GPs coming together to make decisions (when most practice meetings come to blows over which brand of coffee to buy).

We need to put up our fists and stop behaving like gentlemen

Extraordinary to see the rage that was manifested when someone proposed the agenda be thrown out completely (I mean, why hold a vote just on the agenda anyway?).

I repeatedly asked my colleagues, ‘is it normally like this?’ They looked back, nonplussed.

And this sums up the problem. We stick to our rule books and procedures while the Government plays dirty tricks. They don’t care how hard we work. They don’t care that we’re making ourselves ill to prop up primary care. We are assuming they are gentlemen. They aren’t. While we argue about an agenda, maybe we should rip up the rule book and think like Whitehall.

The bulk of the day was underwhelming. I wanted action. I wanted concrete proposals to push to the GPC and say: ‘Here! This! Now listen, get on and do it.’ Instead we argued over wording and nuances, and rejected perfectly good motions because of the phrasing and the what-ifs.

After a frustrating day, the only bit that gave me hope was the very last motion nudging us closer to mass resignation. This time, people ignored the minutiae. The passionate speeches helped (Dr Katie Bramall-Stainer was simply incredible) and although many colleagues were concerned, it was carried.

But after the high came the let-down. It was scarcely reported in the press, which focused instead on our wanting to ditch all older patients because we are ‘too lazy’ to do home visits. Then, despite all the junior doctors’ activism, the health secretary imposed his new contract on them. All this has shown me that we need to do more. To fight more imaginatively, dirtily.

It is time for the GPC to withdraw from negotiations and poll the profession on our priorities for any new contract. Next, the BMA needs to hire a good PR firm whose job is to counter the rubbish in the papers. Do it on the sly if necessary. Or let’s crowdfund it.

Then, get some actual costed, concrete proposals for how we can reject contract negotiations or an imposition. Yes, we could resign, but what else? Give locums, salaried GPs and partners different choices because our circumstances are all different.

Then, focus on unity. We’re scared of hurting patients and losing our jobs and homes. But when your practice is the next to close, those things happen anyway. We have to fight back so let’s do it on our terms and with a purpose.

Following the rule book has not worked. We need to put up our fists and stop behaving like gentlemen.

Dr Zoe Norris is a GP in Hull

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Readers' comments (24)


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  • Hear, hear!

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  • I rather enjoy being able to charge what I am worth. What if GPs charged for premium consultations eg after 5pm. I feel you are going to have to think outside the square and do lots of different things individually and collectively if you are to sustain General practice and your sanity.It is time for collective civil disobedience. Kept very civil of course.

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  • I fully support you, Dr Norris.

    I think we need to grow a pair and get on with it.

    I am sick and tired of the old boys (and gals) in our profession who keep harking back to some bygone day that will never return, and keep talking about the minutiae.

    Just do it - STRIKE, stop acting as a gatekeeper to secondary care, stop doing any more unpaid work, stop being dictated to by NHS England who clearly are a bunch of idiots who dont know what they are doing (see the last select committee when they were asked about the JD contract and simply had no answer).

    Lets get this done. We need to mobilise and get on with it.

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  • Unity is overrated. I sincerely hope that the GPs do not follow JDs in a pursuit of public support.

    Leave politics to plebs, you are professionals, who are supposed to be above it ffs.

    Follow GMP, raise safety concerns and safeguarding regarding every single bit of work leaking out of the hospital that should not do. Load up the local CCG's duty of care and sue them if they do not demonstrate that they are contributing adequately to your sustainability. Do not sign a single enhanced service/local improvement scheme/public health contract unless you can identify a 30-40% profit margin.

    Be ruthless in the pursuit of quality and all the nonsense will fall away by itself.

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  • Spot on as always Zoe. It was an extraordinary thing to witness for the first time.
    The profession has, I think, been naive previously and always thought they must just get on with it in the name of professionalism.
    What is professional in my mind? To tell the politicians what a good job we do, how they have no idea how much these professionals will cost if we lose our contractor status and to do this because we know that high quality medicine coupled with continuity of care is what is best for patients.

    To do this, we need to stop playing nicely and stand up and be counted.

    "Oh but the patients will suffer"? They will suffer a hell of a lot more if we don't.

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  • Nhsfatcat

    Comparing the behaviour of disgruntled, fed up , angry but dedicated GPs at the conference and yesterday's PMQs speaks volumes as to why we need the politicians to shut up, listen and then have a proper discussion. They need to engage with all the healthcare professions tehn go back to the Chancellor; if he says no then the politicians need to get on board with us or cut us free.

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  • Anonymous | Practice Manager25 Feb 2016 12:25pm

    Horseshit. You'll go bust first.

    Just resign and go private. TUPE your staff to a Ltd and start over. If enough locally do it the NHS will have to buy back from you.

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  • Well said Zoe We as a profession have been 'the nice guys' and look where that got us! We need to unfortunately fight them tooth and nail and get some decent PR behind us Something to actually fight our cause and stop this continual dissemination in right wing press of us and in fact all profession We tried the way of not stooping to their level but guess what- they don't care a toss and hold this sword of Damocles over our heads that we can't let patients down nor cause harm Of course we don't but if GP collapses along with rest NHS then patients will suffer harm and HMG to blame so we need to fight and fight as dirty and hardcore as they do To hell with being 'too nice'

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  • Agree - time for BMA to abandon the tedious nitpicking procedural niceties of conference/ARM, have a proper open debate and discussion of the issues and then write the legalistic policies once the real views of its members are known, instead of wasting speaking time at the conferences on debating society protocol.

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