Fears over ‘diluted’ GP contract negotiations as Government states it merely ‘consulted’ BMA

Exclusive GP leaders have expressed ‘profound concern’ after the Government said discussions around the 2024/25 contract in England were a ‘consultation’ with various groups, and not a ‘negotiation’ with the BMA.

Current and former BMA GP Committee negotiators said the wording seems to be ‘diluting’ the union’s role in setting out terms and conditions for general practice.

The GPC chair told Pulse that the Government had used emergency Covid legislation to change the talks from a negotiation to a consultation.

It was also revealed that the ‘consultation’ was co-chaired by the Department of Health and Social Care and NHS England, and involved ‘patient representatives, Integrated Care Systems and other key stakeholders’, as well as the BMA.

There are further suggestions that NHS England was not given ‘a mandate’ from the Government to negotiate a contract with GP leaders for 2024/25.

Last week, NHS England primary care director Dr Amanda Doyle said that the contract will make only a ‘tiny difference’ to practice workloads, and said her team were given ‘no option’ to go about the funding set out by the Department of Health.

According to GPC England chair Dr Katie Bramall-Stainer, the Government used emergency Covid legislation in the pandemic ‘to transmogrify’ the annual negotiation into an annual consultation.

As the doctors’ trade union, the BMA ‘have bargaining rights’ in respect of all employed doctors in the NHS – whether or not they are BMA members – and members and officers of their branch of practice committees ‘sit on joint negotiating committees and produce guidance on the implementation of national agreements’.

Dr Bramall-Stainer said: ‘GPs may well be wondering how we could be facing our third consecutive contractual imposition under this government, when prior to the PCN DES, impositions were scarce.

‘Concessions could usually be determined, on both sides, to agree revisions to the contract each year.

‘The fact is, that emergency Covid legislation was used in the pandemic, to transmogrify our annual negotiation into an annual consultation. This is significant, and a profound cause for concern.’

However, she said that a new ‘substantive’ contract for practices would still require a formal negotiation between the Government and GPC England.

GPC member for North Yorkshire and Bradford Dr Brian McGregor said that the language used identifies ‘how NHSE and DHSC are now approaching the profession of general practice’.

He added: ‘What we have always seen as negotiations they now refer to as a consultation, and the imposition for a third successive year they now refer to as an implementation.’

He also said that there are ‘multiple concerns with regards to the lack of respect for the profession’.   

Former GPC chair Dr Richard Vautrey suggested the Government uses the term negotiations when they’ve reached ‘a positive outcome’, and consultation when ‘they impose a contract change’.

He told Pulse: ‘The reality is that negotiations have been taking place and most importantly will need to happen again in the future if a contractual agreement between GPC England and NHSE is to be achieved.’

Another GPC member, who asked not to be named, told Pulse that the change seems to be ‘diluting’ the BMA’s power to influence the decisions.

The Department of Health and Social care told Pulse that the contract consultation took place in summer last year, engaging the profession, patient representatives, ICSs and other key stakeholders via an Expert Advisory Group.

It said the consultation was co-chaired by DHSC and NHSE and had informed the priorities of the 2024/25 GP contract changes.

Following this, from October to January, the DHSC consulted GPC England on formal policy proposals. DHSC and HNSE then considered GPC England’s feedback, which was provided in regular plenary, working level meetings and in writing and made a number of changes in response.

DHSC also explained that it used the term consultation as this more accurately reflects the engagement with GPC England, both for 2024/25 and historically.

A spokesperson said: ‘We have not used emergency Covid legislation in relation to the GP contract, and any suggestions to the contrary are false.

‘Changes to the contract are always a consultation – not a negotiation. We consulted the General Practice Committee of the BMA and made a number of adjustments to the contract in response to their feedback.

‘GPs are at the heart of our communities, and we hugely value their vital work. This will help reduce unnecessary and burdensome bureaucracy so they can spend more valuable time with their patients.’

Pulse has contacted NHS England for comment.

Despite the 2024/25 contract being imposed, with NHS England saying it is final and will now be implemented, the GPCE has gone ahead with a referendum on the contract changes open until 27 March.

The exercise will inform the GPC’s efforts as it explores possibilities for industrial action.

Note: This article was updated at 23.20 on 12 March to include a new statement provided by the Department of Health and Social Care.