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Government must stop ‘bullying’ GPs over the contract changes, claims GPC

The GPC has accused the Government of ‘bullying’ GPs over the contract negotiations for 2013/14 saying that it is perpetuating a culture highlighted by the Francis report as part of the reason behind the unsafe care provided at Mid Staffordshire NHS Foundation Trust.

GPC chair Dr Laurence Buckman said that he hoped ministers would listen to a detailed consultation response it published yesterday to the Government’s proposed changes to the GP contract in England, but he claimed that the profession was being forced into accepting the changes by an intransigent Government.

He also raised concerns about the way CCGs were being held to targets by payments in the Quality Premium and the gagging clauses placed on some GPs by CCGs, as revealed by Pulse last year, saying that these were also symptomatic of encouraging a ‘silence culture’ in the NHS.

Dr Buckman said: ‘[The] analysis document shows yet again, that if you can’t get what you want, you bully people until you get what you want, and this is not just about the NHS, but about the Government’s attitude to the people who work for it - in this case GPs, but it could equally apply to other people.

‘To say “we want, and if you don’t agree we are going to force you to do it anyway, is exactly the example of NHS culture that Robert Francis was talking about, and exactly the culture that we are trying to stop.

‘It isn’t about one person, it is much bigger than that. The whole way of thinking, from the very apex of Government, down to the managers immediately above the workers, has to change. Robert Francis was quite right and the example of saying: “Do it or else we will make you” is where we are now.’

He added that their consultation response was ‘very detailed’ and that he hoped the Government would listen.

He said: ‘There is still a consultation period. We are still talking to Government officials and the NHS Commissioning Board but I am under no illusion that the imposition [will happen], unless the Government chooses to listen.’

The GPC also said that gagging clauses given to CCGs were part of the problem. He said: ‘This seems to be exactly the silence culture that Robert Francis was criticising, that you can’t speak out, you can’t say what is going wrong, what is going on, and we think that is very worrying.’

The GPC warned the Government that it is making the ‘same mistakes’ as led to the Mid-Staffs care scandal by driving a ‘target-focused’ agenda both in the GP contract and in CCG management, with the quality premium.

Dr Buckman said: ‘The fact is that money will change hands if budgets come in at a certain number. These are still proposals [and] the Government needs to look at if they can do QP at all. If they do, the CCGs will have to look at whether they can do it in a professional manner and if targets are achievable.’

‘Francis talks of targets [and] this Government came in talking about removing targets – but what is the contract imposition? A lot of targets. And now CCGs will be working to targets.’

A Department of Health spokesperson said: ‘We have held a consultation on our proposals so we can hear the views of GPs and other stakeholders, we will consider all responses carefully and respond in due course.’