Doctors attending the BMA’s Annual Representative Meeting (ARM) have voted in favour of GP practice withdrawal from PCNs by next year.
The vote was passed with 61% voting in favour, 12% against and 27% abstaining.
Representatives also voted to instruct the BMA England GP committee to ‘act upon the GP ballot of 2021 and to organise opposition to the imposition of the new contract including industrial action if necessary’.
57% were in favour of potential industrial action, while 17% voted against and 26% abstained.
The motion, passed in full, also called for PCN funding to be moved into the core GP contract, with 64% voting in favour.
Proposing the motion, Tower Hamlets LMC chair Dr Jackie Applebee said: ‘PCNs should be abolished along with all the box-ticking.
‘Money should all be paid into core to allow us to determine how services are delivered.’
She added that GPs ‘should be held accountable for this funding’ but that this is ‘not a difficult problem to solve’.
Dr Applebee said: ‘I appreciate that some of you will be against abolishing PCNs. I understand that general practice needs every penny it can get and that the funding attached to PCNs can incentivise GPs to try and make PCNs work, but the truth is that often PCN services struggle to break even.
‘If practices wish to work in networks, they can choose to do this funded from their enhanced core budgets, without the straightjacket structure that is the current PCN contract.’
And she urged delegates to ‘channel our inner Mick Lynch’ – leader of the National Union of Rail, Maritime and Transport Workers – saying that while there are some ‘who will be worried about industrial action’, GPs are not ‘powerless to act’.
‘We are heading for oblivion if we don’t have the courage to fight for ourselves’, she added.
But speaking against the motion, GPCE deputy chair Dr Kieran Sharrock said that in the 2021 indicative GP ballot ‘there was not a strong appetite for industrial action’, although it ‘did indicate displeasure with the PCN DES’.
He added: ‘If there had been, we would have acted on it. Following the imposition of the contract in April this year, the profession may have changed its mind, so if we hear that your mood has changed, we will listen.
He told delegates: ‘LMC conference has voted the PCN DES to be an existential threat to the GP contract, however many GPs do not believe that.
‘Many GPs like the PCN DES, they think it’s helped them and their patients, [and] many GPs have asked me personally to negotiate a contract that supports collaboration and working at scale.’
And GPCE chair Dr Farah Jameel added that while PCNs ‘have presented for many a recurring sore’ thanks to ‘their micromanagement’, they are ‘seen as a lifeline’ for ‘many’.
She told delegates that the indicative ballot results were ‘not enactable’ because ‘the majority of the profession did not vote’.
She said: ‘It was an indicative ballot – let’s call it a glorified survey – and it did not meet the threshold to go out on industrial action.’
But BMA representative body (RB) chair Dr Latifa Patel confirmed that the RB ‘can instruct GPC England to act on’ the ballot and ‘organise opposition’ to the imposed GP contract, including ‘industrial action if necessary’ – as set out in the motion.
She said: ‘We have had an opinion from our legal team and RB can instruct GPC England.’
The 2020 England LMCs’ conference had voted in favour of a similar motion, meaning this should have already represented GPC policy for the last two years, but Pulse understands this is the first time the GPC has actively voted for the policy.
The BMA’s indicative ballot in November showed over half of GP practices were willing to opt out of the PCN DES as part of a range of protest measures concerning the Government’s GP access fund.
Motion in full
Motion by LONDON REGIONAL COUNCIL: That this meeting supports GPs fighting to defend the GMS contract and NHS independent contractor status. The long-term GP-patient relationship and the right for GPs to control their workload in a safe way is essential for the future of general practice. We applaud the South Staffordshire motion passed at the 2021 LMC conference which called for GPCE to negotiate the end of the Primary Care Networks (PCNS) from 2023 as they ‘pose an existential threat to independent contractor status’ and this meeting:-
i) calls on GPCE and the BMA to organise the withdrawal of GP practices from the PCNs by 2023; PASSED
ii) calls for PCN funding to be moved into the core contract; PASSED
iii) instructs GPC England to act upon the GP ballot of 2021 and to organise opposition to the imposition of the new contact including industrial action if necessary. PASSED