The GPC's response to the NHS reforms was compromised by division, PCTs have played on tensions within the profession to launch a wave of PMS reviews, and there is still no resolution to the MPIG fiasco because of different views among practices in deprived and more affluent areas. So it is worrying to learn that the profession's response to the Government's pension changes is beginning to splinter – and particularly that it is doing so along age lines.
There have been tensions between older GPs and their younger colleagues ever since the 2004 contract handed practices an active financial incentive to recruit salaried GPs rather than take on partners.
A number of leading GPs, including GPC chair Dr Laurence Buckman, have warned those divisions threatened to weaken the profession. There are now signs the prophecies of doom are becoming reality, as the generations begin to drift apart in their views on the BMA's planned ballot on pensions action.
The arguments on both sides are wholly reasonable. Younger GPs are furious they face having to pay as much as £200,000 extra over their lifetime in pension contributions – and given many are in salaried positions rather than partners, they see little drawback in taking a militant stand against the Government.
Older partners are no less outraged at the Government's pension plans, but they are more cautious, bruised from previous occasions where the profession incurred the wrath of the national media, and nervous that boycotting routine care will do nothing except load practices with a nightmarish backlog of workload.
And while many older GPs are speaking out on behalf of their younger colleagues, those within 10 years of retirement are spared the worst of the changes, so don't have quite the same personal motivation to take action. The Government is very clever when it comes to the game of divide and rule.
So what should be the way forward, as LMCs report increasing nervousness at the prospect of a vote for industrial action?
Pulse's Say No to 30% campaign has called for GPs to vote Yes in the ballot – to provide the BMA with ammunition for its negotiations with ministers – but we also warned the planned protest would leave GPs ‘exposed to the full fury of the press', and that future action should focus on non-clinical work. The BMA must reassure GPs who fear a day's boycott of routine appointments will bring unpopularity but no benefits that it will be backed by future action targeted at the bureaucracy of healthcare. LMCs, too, have a responsibility, to support practices in addressing the workload issues and avoiding any possible contractual disputes. They can play a key role in rallying the profession behind a strong vote in support of industrial action – even if some of those GPs who vote Yes choose not to take action themselves.
Only by presenting a united front can the profession win this fight.
Click here to take part in our BMA pensions ballot survey
