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Tight vote sees LMCs reject exploration of new GP contract models


GP contract models


In a tight vote, GP leaders have rejected a bid for the BMA to explore alternatives to the current GP contract models.

The motion, debated today at the UK LMCs conference, had called for research into the creation of an options paper investigating the ‘benefits, risks and costs associated with the provision of general practice outside of the GMS, PMS and APMS contract model’.

Although 53% of 258 delegates did vote in favour of the controversial motion, it failed to reach the two-thirds majority required to pass.

Proposing the motion, Cambridgeshire LMC’s Dr Nathalie Rodriguez-McCullough said: ‘I’m more concerned than ever about the sustainability and future of partnership and general practice. In England, we know there is an ongoing divestment from GMS into PCNs, with an eye on integrated care systems… where the voice of general practice and LMCs is being severely diminished.

‘We are expected to just get on with it, to trust grown ups in Government and companies to plan the future around us and for us. Our destiny can be in our hands, but we need the tools and we need to be proactive here, not reactive.’

She added that the motion had not been calling for ‘radical change or privatisation’, rather simply proposing a concerted piece of evidence be put together to provide evidence and ‘realistic choices’.

Supporting the motion, Kent LMC member Dr Zishan Syed said GPs can’t be expected to meet the healthcare needs of our population ‘with an all-you-can-eat contract of £93.46 for an infinite number of attendances per patient per year’, and called for ‘an activity-based contract’.

But speaking against the motion, Lambeth LMC chair Dr Penelope Jarrett said she considered the wording of the proposal ‘ambiguous’, adding that when she read it, she saw it as ‘promoting other forms of contract, and in particular, the possibility of private provision’. 

She added: ‘We have a very good arrangement in the GMS contract. Every time we have tried to move away from that, things have gotten worse. We’ve had PMS and more recently, APMS contracts, which have led to their own problems. In particular, I would highlight increasing inequalities and fragmentation of care.’

It comes as healthcare campaigners protested against a takeover of dozens of GP practices by a company with ownership ties to a US healthcare giant last month, calling it an example of an ‘accelerating privatisation of the NHS by stealth’ – a development referenced by several LMC representatives debating today’s motion.

Motion in full

That conference calls upon GPDF to commission and fund research into the creation of an options paper for GPC UK to review prior to April 2022 that will investigate:

  • (i)  the benefits / risks options and costs associated with the provision of UK general practice outside of the GMS / PMS / APMS contract model REJECTED
  • (ii)  how those independent contractors who wish to become employed GPs may be facilitated to do so with regard to their estates and premises across a number of examples on a local, national or UK basis REJECTED
  • (iii)  modelling around the longer term consequences of risks/benefits to practices of having aligned contracts with staff and / or premises with other NHS providers / trusts REJECTED
  • (iv)  how the future of a separately negotiated model around NHS and non NHS provision of general medical services could be facilitated. PASSED AS A REFERENCE

Source: BMA

READERS' COMMENTS [4]

Dave Haddock 13 May, 2021 9:19 am

BMA persistently puts the interests of the NHS before of the interests of doctors. Why do people fund this parody of a union?

Thomas Robinson 13 May, 2021 11:12 am

Excellent question Dave, I always wondered.

No research and not the sort of thing the BMA themselves are likely to ask. However from my extensive experience at the bar, after learned academic lectures, and indeed often during them.
1 Young doctors think it is the thing to do, nobody educates them
2 Quite a few doctors work in some capacity for the BMA LMC RCGP ETC, and tend to belong, as part of the package.
3 There is a comfort of thinking you are part of a group, be it football club, or political organisation
4 It used to do other things like providing industrial relations advisers, not everyone knows they are gone
5 Hope springs eternal; possibly one day they will get something right.
6 Status, part of the whole thing of having Dr in front of your name
7 Conscience;feeling you are somehow doing the right thing

Added to this is a certain mindset that wishes to be led, and feels that authoritative organisations know best, and should be trusted. They also feel the BBC is impartial, politicians are basically trustworthy, and most mind numbingly of all, that the NHS works.

John Evans 13 May, 2021 11:51 am

GP self perception = dedicated and altruistic.
Employers perception = moaners and cowards.

When the proportion of partners (worried about premises and redundancy liabilities) is reduced there may be an appetite for unified assertive action. Save enough to cover 6months living expenses to liberate you to take such action should you finally decide to stand up to abuse.

The direction of travel is obvious – squeeze GPS until GP professional status is lowered or corporate systems have sufficient capability – at that time it will be checkmate. Good luck.

Mr Marvellous 13 May, 2021 5:48 pm

Let’s not even EXPLORE other funding models, lest we upset the NHS.

(Even though the NHS is probably the UK’s biggest abusive employer and is largely the reason for so much dissatisfaction in the medical profession).

The BMA absolutely values the NHS over Doctors.