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LMC to defy BMA industrial action plans while others deliberate


Dr Dean Eggitt


Exclusive An LMC has told practices it will not ask them to disengage from NHS England’s GP access plan or take part in industrial action, Pulse has learned.

Doncaster LMC said the BMA’s ballot for industrial action is ‘likely to harm negotiations rather than help’ and that it will instead work to ‘positively influence national policy’.

In a letter sent to practices last week, seen by Pulse, Doncaster LMC said the BMA had asked LMCs to confirm whether they would disengage from participation in NHS England’s plan, collect undated resignations from the PCN DES and attend every CQC practice visit.

The letter said: ‘Doncaster LMC has currently chosen not to request that practices disengage or provide undated resignations. We have always maintained support for CQC visits where this is requested.’

The LMC will continue to work on practices’ behalf to ‘create and benefit from positive relationships with providers and commissioners continue to do everything [it] can to positively influence national policy’, it added.

Doncaster LMC chief executive Dr Dean Eggitt’s letter said: ‘We believe that general practice is in dire need of support. We need sustained investment in workforce, buildings and IT infrastructure. We need to minimise unnecessary paperwork, meetings and oversight.

‘To achieve this, we need to have trusted and respectful relationships between leaders of our profession and NHSE and the Government. We do not currently have this.’

It added: ‘It is our current belief that the motion from GPC England and the ballot for industrial action is likely to harm negotiations rather than help, resulting in Government policies that will alienate general practice from the NHS family.’ 

Dr Eggitt told Pulse that the LMC doesn’t agree with the current BMA GPC position or believe ‘any form of industrial action at the moment is warranted on this topic’.

He said: ‘That’s not to say that we’re in disagreement with how general practice is being treated, or the current Government approach to managing the NHS. We vehemently disagree with many of the policies, but we don’t believe that GP industrial action is the way to solve the problem.’

And the ‘battleground’ chosen for industrial action – declarations of pay above £150k and Covid vaccine medical exemptions – means GPs ‘won’t have the public in our favour and therefore we’ll lose’, he added.

Dr Eggitt said: ‘If we lose, we damage not only the relationship with patients but also with Government, not just now but for years to come. So this industrial action is possibly harmful rather than helpful.

‘If we were saying we want industrial action because general practice has become so unsafe for patients that we’re causing harm and therefore we demand investment in workforce, that’s a perfectly reasonable argument.’

His letter to practices added that there was ‘clear division within the profession’ at a nationwide event held last month by the BMA’s GP Committee to discuss ‘next steps’ following the publication of the access action plan and attended by the LMC.

Meanwhile, other LMC leaders have told Pulse they are awaiting further BMA guidance and feedback from constituent practices before deciding on their position.

County Durham and Darlington LMC vice-chair Dr Kamal Sidhu told Pulse the LMC had an emergency meeting last week and is still clarifying what is required from practices and what it will advise them.

He said: ‘We as an LMC are still discussing it between ourselves – the implications for practices, particularly the partnerships – and we haven’t formally given advice either way as yet. We’ve simply communicated the information from BMA GPC to the practices.’

The LMC will ‘probably’ wait for feedback from practices before it decides but practices and primary care networks are still ‘debating’ among themselves what action they want to take, he added.

And Lancashire and Cumbria LMCs chief executive Peter Higgins told Pulse that the committee is ‘proceeding with caution’ and awaiting ‘further advice and guidance’ from the BMA before making a formal decision on what advice to give practices.

Lincolnshire LMC also held an emergency meeting last week to discuss its position, inviting all practice managers and GPs across the country to share ‘what they want to do’, medical secretary Dr Kieran Sharrock told Pulse.

It comes as GPs are expecting further guidance from the BMA, which also advised practices to immediately start offering consultations of 15 minutes or more; and apply to close their patient list, as part of the fightback against the Government’s new GP access plan.

Both the BMA and some LMCs previously advised GPs ‘not to engage’ with the measures outlined in the access plan.

Meanwhile, new NHS England guidance last week revealed more detail of the hoops GPs will have to jump through to access the £250m winter funding, as well as confirming that some practices needing access ‘support’ will not be eligible for the GP winter access funding.

READERS' COMMENTS [17]

Alistair BLAIR 1 November, 2021 2:38 pm

The BMA and GPC are very disconnected from reality on the ground at times, as this decision reflects

Patrufini Duffy 1 November, 2021 2:39 pm

Ah yes: “we damage not only the relationship with patients but also with Government”.

Define patient and define public. They’re different in the 21st century. And this is the exact heartstring and poetry they keep playing you on, because they know that’s your default half-blind-altruism and self-reasoning for doing nothing. Dentists, solicitors, private sector and bankers look on whilst you clear go in zig zags and keep clearing out the social gutter.

Grant Jonathan Ingrams 1 November, 2021 2:40 pm

I am not sure what is worse, the fact that Doncaster LMC believes that continuing to do the same thing (talkng to NHS England) is miraculously going to work when it hasn’t for many years, or the fact that they are pround of this and are highlighting it in public. As Albert Eistein (may have) said “The definition of insanity is doing the same thing over and over again and expecting a different result.”

Nigel Dickson 1 November, 2021 3:06 pm

Is Dr Eggitt reflecting the opinions and feelings of his GP employers in Doncaster – I doubt it – sounds like he is talking for himself and his own views? Is he hoping to stand as a conservative MP at the next election – looks like it from his outburst?

I thought LMC chief executive’s were supposed to be apolitical in their advice to their employers?

May be its time for Doncaster GPs to sit up and be counted by submit a vote of no confidence in their chief executive?

Cameron Wilson 1 November, 2021 3:23 pm

Utterly predictable! There’s absolutely no respect for GP from NHSE or HMG, arguably not surprisingly! Doncaster LMC can watch the exodus along with HMG/Daily Mail/NHSE. The BIG mistake is that instead of industrial action we should have been working up a viable plan B! This should have be done whilst there were still troops on the ground and not accepting the scraps off the table eg 200quid for a session, and not exposing those troops to the unwinnable end game with the GMC etc waiting in the wings! Everyman for himself it is!!

Andrew Marshall 1 November, 2021 3:30 pm

Dr Dean Eggitt does not have the support of many Doncaster GPs and I have expressed to him my bitter disappointment at this misguided (in)action, which came as a massive surprise.
I note that other LMCs are properly canvassing their membership and I hope that our pathetic response will be not be mirrored by many other LMCs.

PAUL BALLINGER 1 November, 2021 3:57 pm

At long last an LMC with a sensible constructive approach

Michael Mullineux 1 November, 2021 3:57 pm

‘Positively influence policy? Seems pretty delusional considering the complete lack of positive influence to date with the relentless handing down of ever more NHSE PCN diktats. However, the ‘better in than out’ way of thinking (if you can call it that, seems pretty brain-dead to me) is all too common amongst GP colleagues, who will soon be the only ones left supervising vast armies of ARRS as GP’s continue to depart in their droves.

Keith M Laycock 1 November, 2021 4:20 pm

As always: – ‘United (you) stand, Divide (you) Fall) ……. guess which it will be this time?

David Turner 1 November, 2021 4:21 pm

I would make a bet this decision has bene made by GPs who do a minimal amount of work at the coal face.

Alan Woodall 1 November, 2021 5:45 pm

Words fail me.

Matt Hancock 1 November, 2021 7:55 pm

This GP’s day sounds far more exciting then any I’ve ever had in my career. Sounds almost too exciting… as if its made up

C Ovid 2 November, 2021 2:09 pm

So, now we are a divided profession. DoH 1 GPs nil. … and elsewhere in today’s Pulse news “Although the GP headcount in England had risen by 1,385 since the 2019 general election, when this promise was made, the number of full-time, fully qualified GPs had decreased by 105.”
Never a better time to act. The further we get from the end of the pandemic, and the closer to an election, the harder it will be for the Govt to compromise. At the moment, they can spin off any bad news or big changes as “immediately necessary” and they would be “easy to bury” amidst Brexit, French fishermen, China, COP26. And… they wouldn’t have a lot of time or energy to devote to this as they have lots on their plate. We would have to provide a lot of “oven ready plans” to make it easy for this bunch of Political B-listers.
Cry havoc, lets get going.

Christopher Jones 3 November, 2021 8:07 am

This sort of half-soaked, wet blanket approach is what has permitted general practice to end up in the terrible state it is now in.
We have reached the point in time where we need to amputate an arm (metaphorically) to save a life (possibly literally).

Finola ONeill 3 November, 2021 12:24 pm

In my opinion this was not the LMC’s call to make.
It is the practices who should be asked and this unilateralism is undemocratic.
I also believe it is misguided.
The BMA does not have much experience acting as a typical union. Maybe they should ask other unions’ advice,
But the basics go like this. The union ballots members (or in this case practices has they hold the contracts) and then based on those responses a decision is made.
Local rep groups of the union don’t make unilateral decisions.
That is both undemocratic and undermining.
Unified democratic action is required for any union success and bargaining power and this LMC is undermining that.
I strongly suggest they retract and await their practices’ response.
Does the BMA and LMC’s not have rules regarding these things?
If this LMC is in breach of any I suggest they are given the opportunity to rectify or be removed.
If there are no such rules we need a new union that has workable rules.
ASAP.
Lastly. There are other options beyond practice actions and breaching contracts.
Individual doctors can be balloted as to what action they would be willing to take.
This is not about a power struggle.
This is about patient safety and a sinking primary care and a sinking NHS.
The Pandemic taught us that to fail act when needed is as dangerous as to act in error.
Doctors and GPs tendency to be conservative and conforming in nature can be at opposition to our duty to our patients.
I don’t think this is the time for more pandering to NHSE and the government.
Go get some advice from the big unions.
And then stick with your guns BMA.
Or if it is not possible for practices to make a stand as they are worried about implications of breaching contact then please ballot members as there are actions we can take as sets of GPs rather than at a practice level that won’t be in direct breach of contract.

Syed Shah 3 November, 2021 6:21 pm

I absolutely agree with you ONeil.
Individual GPs should be balloted as to what actions they would be willing to take, as at practice level, ‘partners’ are worried about the implications of breaching the contract and for the sake of agreement, they stay silent. Please remember that this is just an indicative vote and if the practice vote is already diluted , it just becomes a pointless exercise.