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Gold, incentives and meh

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)

  • As a first act of collective defiance, maybe we should ALL refrain from posting our incomes on our websites, from 1/4/16 onwards.

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  • I was another conference virgin and was also amused by all the nitpicking over wording. I did, however, vote to get rid of the agenda and start vote on sone real action.

    If our funding and respect do not increase significantly, the ONLY way forward is for the GPC to facilitate truly independent practice by liaising with our dental colleagues.

    But we know they will not do that as they keep promoting working at scale as the only way to sustain ourselves.

    Meanwhile, Rome continues to burn....

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  • Gloves. Off. Now.

    Listening, Chaand?

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  • and yet Zoe, when the Birmingham RCGP faculty got the chance to oust Steve Field from their executive, they chickened out by 12 votes to 6 and voted to retain him, this shows me the cowardice of the profession when push comes to shove, there are too many scared GP's out there to effect any real change!

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  • There is an ancient Chinese curse: "May you live intersting times!".
    I find politicians as a species fascinating, and they are generic(see Paxman's excellent tome: "A political Animal").Whatever our "agenda" we must accept that we have to align it with the Government's.The first aim of any politician is to get re-elected.They know the public understands the concept of a "7day NHS", and does not give a stuff about fancy BMA lawyers and "equality impacts".
    GPs need to step back from byzantine debates about agendas and acknowldege that the arithmetic of GPs retiring v. trainees joining means that General Practice as we know it will cease to exist in 10 years time.
    We must wrest back control of the debate and give the government solutions not problems. "Cottage industry" small Practices in semi-converted Edwardian terraces have no place in 21stC Primary Care. Buy us out, we are clinicians not property developers.Give us shiny new Primary Health Campuses, 50 GPs, one Practice management team, Physios down the corridor, Health Visitors, CPNs and midwives next door on the left, and the Rheumatologists et al running clinics here every Thursday.

    Get real guys and gals, or book your one way ticket to the Antipodes.

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  • Secure environments GP

    Short article I published last year, and thought I had over-egged it. Maybe not...

    NHS GPs are losing this "game of chess" with the UK Government
    Jul 11, 2015

    NHS Primary Care as we know it is dying by a thousand cuts.

    Primary care in GMS / PMS forms are becoming unable to provide the high level of service that is expected from its patients and standards expected of its Regulators. As Noam Chomsky said:

    ‘If you want to privatize something and destroy it, a standard method is first to defund it, so it doesn’t work anymore, people get upset and accept privatization."

    Mr Hunt (Health Secretary) is pushing a privatisation agenda. They obfuscate this, deny it but it "hides in plain site". NHS primary care wasn’t broken and didn’t need fixing. "Failings" in rationing resources are now GPs fault through CCGs, lack of 24/7 services is our fault, etc etc long list ,all our fault, but the Health and Social Care Act 2012 removed the health secretaries "duty" to provide a national health service! All devolved now...

    Jeremy Hunt co-authored a book in 2009 calling for the NHS to be dismantled. See Or Google "the green benches jeremy hunt"

    The profession is divided. It will take those GPs without retirement "in sight" to really "grasp the nettle". To make our choices or force our futures and put ourselves back in the best possible position to serve our patients.

    It's a game of chess and the RCGP and GPC are outmaneuvered EVERY time.

    Mr Hunt was put in position for the "long game". He knows what he is doing and is no fool as some may think. My belief is that collectively GPs have to be smarter and more ruthless than he is at protecting our position which we then know serves the best interest of our patients.w

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  • You need to start by forming a gp facebook group, the junior one is an excellent way of haring information and humour

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  • She is absolutely right the politicians do not have a caring agenda it is money money and power they have been trying to get rid of NHS free at point of delivery for ages as their backers can't make money out of it .They have smashed the unions and now the professionals For the sake of fair health care for all WISE UP and fight while we still can

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  • "Then, focus on unity"
    Oh Zoe, I can also hear you saying: "The trust I have is in mine innocence and therefore am I bold and resolute."
    General practice is riddled with vested interests. The vast hard-working majority are led like sheep by the handsomely rewarded "colleagues" of the governing bodies who quite often sit on the LMC of their area, and the BMA regional offices, and NHSE committees, and RCGP boards, and health boards and you name it. They are known as our "leaders", you know, those gong-grabbers.
    I have absolutely no intention of giving up my contract. Instead, I have resigned from the above bodies.
    Do you want general practice to survive? Threaten a mass resignation from the BMA, LMC and RCGP - then you will see real action from our "leaders" fighting for their privileges.

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  • Zoe nice thought but is it Cart before the horse......
    LMC showing teeth? Vow What a surprise!!!
    This hype won't last. Been on LMC in what some one said in by gone ear. Members looked after themselves and didn't give too hoots about others. When raised the issue was ridiculed and hounded. Look where are we now when those voices were drowned by so few supposedly area representatives. Few of those used that to further their careers and rest were nodding dogs. And that's why we are in this situation. I had to tell the committee the home truth that they stink and for own sanity walked out to concentrate to do the real General Practice as coiuld not stand two faced bigots and that was in 1998.
    But by those leaders and few with no backbones the damage to the GP community gas already been done.
    Strike forget it, work to rule might work. Find some real sensible weapon to fight than going for sensational headlines.
    Target GMC and NHSE and also defence bodies (last one helps GMC to the authorities by asking clients to plead guilty regardless unless you stand up to them first) look at the morbidity along with the mortality in GP /Dentist community.
    Weed out Judas in the profession- hard task.
    I know few in my part of the world. They are the one who had and still doing the damage to the profession- fellow colleagues. All of us know who they are.
    Speak up now or forever remain silent and SUFFER. Or it might be already too late......I don't know.
    Like it or not you strike and some sod is ready to take over your practice /livelihood. Give ammunition to the government and Help the privatisation and one of your trusted leader will be CEO. Remember GPC pair founded a company using all the knowledge gained on being on it.(it was legitimate but immoral - starting the rot)
    Patient suffering? Do you think NHSE / GMC give a damn?
    I have written to GMC to change it's slogan - Don't give damn about the patients and Screw the doctors. Don't help them more. Bring them to account please.
    I am retired and come back so whatever is done will not affect me. But l do care about the future GPs and GP practice. I am not a leader or leadership material that does not mean I should stop caring.

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