Northern Ireland’s health minister has imposed the GMS contract for 2025/26 on GP practices for the first time, after the offer was rejected by the BMA last week.
Speaking in the Northern Ireland Assembly today, Mike Nesbitt said he has ‘taken the decision to go ahead and implement the contract on offer’ which includes £9.5m extra funding in 2025/26, as he said negotiations had reached an ‘endpoint’.
It comes after last week the BMA revealed that 99.6% of GPs voted in favour of rejecting the offer, which contained an additional £1m into core funding, £5m for indemnity and £3.5m expected to cover National Insurance hikes.
Mr Nesbitt recognised the pressures GPs face from National Insurance hikes this year as well as ‘longstanding concerns’ about indemnity – but he blamed the BMA’s NI GP Committee for tabling ‘unachievable demands’ when ‘budgetary pressures are at an all time high’.
The BMA strongly criticised the decision and said it will ‘now consult with members to decide the next steps’.
In the negotiations, the BMA had asked the Department of Health to agree a 1% uplift in the core GP contract, full indemnity for all GPs and full cost recovery for the increase in National Insurance contributions.
Mr Nesbitt told the Assembly today that has both a ‘personal’ and ‘professional’ interest in ‘supporting primary care’, but he stressed that he did not take up the health minister post to ‘agree to demands the budget could not possibly satisfy’.
He continued: ‘In financial terms, the cupboard is bare and there is no point pretending that I can serve up a sumptuous three-course meal.
‘There is nothing to be gained from further contract negotiations which would only offer false hope that a better offer might be forthcoming. It will not. We are at the endpoint for this year.
‘I have therefore taken the decision to go ahead and implement the contract on offer. I do so mindful of the pressures GPs are facing in relation to National Insurance bills and the longstanding concerns about indemnity cover.
‘I want the funding I have been able to earmark for these areas to be released and to provide immediate assistance. Further delay will help no one.’
The health minister also said that on top of the £9.5m extra contract funding already announced, he expects to make a ‘further £10-20m or maybe £20-30m increase once the pay review body recommendations are decided up on for this year’.
He told the Assembly that the BMA had asked for £80m in extra funding, but that he could not accept this.
‘Giving the GPs another £80 million to do what they are doing, with a vague promise they will sit down to discuss the severe access issues, is not an option I can contemplate – not when there is already a funding gap of half a billion pounds and more in the overall health budget.’
BMA Northern Ireland GP committee Dr Frances O’Hagan criticised the decision, saying the minister ‘seems content with the status quo to continue’.
She said: ‘This is the first time a sitting health minister in Northern Ireland has chosen to impose the GMS contract on GPs, so to say we are shocked and angry at this decision would be an understatement.
‘We have been warning for well over a decade now that general practice cannot continue in the way it has been – trying to meet increasing demand with fewer GPs and insufficient resource, leading to collapse by contract hand backs and closure.’
Dr O’Hagan continued: ‘All GPs want to do is deliver a service to their patients that meets their needs. The funding we require would not only do that, but it would also provide the level of access they deserve, and we want to give. The contract being imposed by the Minister will not allow us to do that.’
