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As it happened: LMCs Conference 2016

16:30 And that’s it for this year!

Plenty of food for thought from the last few days. The stand out story across both days has to be the moment delegates voted in favour of a motion proposed by Dr Jackie Applebee, from Tower Hamlets LMC, claiming they did ‘not accept the General Practice Forward View was an adequate response’ to the crisis in general practice, and ’considers it to be sufficient grounds for a trade dispute’. 

As a result of the motion being carried, GPs could be canvassed on their willingness to sign undated resignations and take industrial action.

15:10 It has also emerged that Dr Stephanie de Giorgio, co-founder of the general practice campaign group Resilient GP, has been elected to the GPC. Congrats! 

14:55 Another motion being debated right now is proposed by Dr Sian White of Buckinghamshire LMC, who argues that as part of NHS England’s Forward View package, asks the GPC to ‘urgently publish a list of procedures and services that are not part of contracted essential and additional services.’

Dr White told delegates that: ’GPs are propping up financially starved practise by limiting their work to their core role’ – she went on to say that ‘if we as a profession continue to act as doormats, we only have ourselves to blame when people walk over us.’

But Dr Jeremy Cox, of Hertfordshire LMC, spoke against the motion – claiming that the conference has voted for lists of GP services to be published many times, but ‘people don’t read them’. He added: ’It’s a waste of GPC and GP time to do it all again.’

The motion, however, was passed in full. 

14:15  And the afternoon sessions are underway – including a debate on ‘new models of care’, with a motion arguing that they are no substitute for the ‘lifetime doctor-patient mutual investment company of ‘old models of care’.’

GPC chair Dr Chaand Nagpaul adds that despite new emerging models of care, the GPC’s positions remains that it will continue to push for proper funding of the core GMS contract. He added: ’So I agree with the motion but don’t feel that new models of care have to threaten the GMS contract.’ 

The motion in full:

That conference believes that ‘New Models of Care’ are no substitute for the lifetime doctor-patient mutual investment company of ‘Old Models of Care’.

The motion was carried. 

12:20 A bit more reaction from that major vote.

Dr Grant Ingrams, from the GPC and a GP near Leicester, said: ’GPC will follow the will of the conference, so we will ask the BMA to ballot and then it will depend upon the outcome of the ballot, as to what step is taken next.

‘At least we are at a position where everyone recognises that there is a crisis, and we are in a position where Simon Stevens is saying it is due to duff policy for the last decade, and everyone agrees the plan which has been put forward won’t deliver. So GPs need to do something. They need to take some form of action to protect their practices, to protect themselves.’

Dr Gaurav Gupta, vice chairman of Kent LMC, said: ‘They need to poll GPs soon because otherwise there won’t be many to poll.’

GPC and BMA Council member Dr David Wrigley: ’GPs have said “enough is enough” and have taken this decision in order to protect patient care. We are seeing surgeries closing around the country because of deliberate Government policy to underfund general practice. Patient care is being compromised.’

12:05 A soapbox session now. Cynics would say the whole nature of this LMCs Conference has been a soapbox session…

11:45 Just a couple more motions to tell you about. The big one (pre industrial action) was on overseas patients only being able to access general practice on a private fee paying basis. That was carried. We’ll have a story coming up on that.

Elsewhere, a motion rejecting the cap on locum fees was passed, if you are interested in that sort of thing.

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11:25 It was quite overwhelming…

11:20 As you can guess, there were a lot of passionate speakers in the debate. Here’s a selection of others:

Dr Jackie Applebee from Tower Hamlets LMC, who proposed the motion:

’The Government can always find money if the will is there, but is the will there? We have to remember that this is a Government determined to drive through austerity… Chaand very rightly said yesterday that we must hold NHS England to account, but how?

’They may have belatedly begun to listen but the GP Forward View does not throw the lifeline that practices need right here right now.

’As other delegates have said: we need jam today, tomorrow it will be too late. So what are we going to do? Are we going to accept the demise of general practice or do we have the courage to stand up for our profession and our patients?

’The Government can’t afford another battle with doctors, so conference, put down a marker. Let the Government know that you are willing to consider industrial action, to preserve general practice.’

Dr Andrew Green, chair of the GPC prescribing committee, who voted against the motion

’What is the juniors’ greatest strength? It is unity. What would be our greatest mistake? To expose disunity. And that is exactly what a call for industrial action at this time would do. I’m sorry conference but we will not get anywhere near that magical 98% – and that will look like a defeat before we have even started.

’GP principals in my area will not sign undated resignations. The implications of being left with redundancy payments, long leases or large capital accounts are simply too great. Conference, I love general practice – I have given my professional life to it – but I will not risk personal bankruptcy for it, and we shouldn’t ask others to do that either.’

Dr Naomi Beer, from Tower Hamlets LMC

‘It takes guts to take risks. We need to take this risk.’

Dr Michelle Drage from Londonwide LMCs

‘It’s constructive dismissal guys. They want ’ a new model’ and their gonna get it, whatever the cost to us. Well guess what – The model isn‘t broken – the model is being broken by those who want to break it. We will stand up for ourselves and what we know to be right.’


10:50 It might be GPC chairDr Chaand Nagpaul wot won it. Here are his comments in full:

’The GPC are servants of the democratic process and that democratic process means representing 35-40,000 GPs, most of whom are not here today. So for me this motion is about that democratic process. It is about actually asking GPs where they stand. I think we know where they stand, we know exactly what they are experiencing, but it is about actually for the first time getting a real idea of what they want us to do, and what they are prepared to do.

’I think also that we should not lose the point that has been made that this isn’t about threat. I think what is important is that people are leaving, and my proudest moment was, like many others have said, becoming a GP… and then I am sitting here and I am actually worried whether my practice is coping today. And I think many of you here today are worried about whether your practice is coping today.

’I’m worried about looking at my emails. I worry about the two weeks of holiday I would like to take this summer. That is the reality and I think that it is right that we find out from the profession their intent and the reality that is unfolding before us.’

10:43: IT’S PASSED! Read the full story here. More reaction to follow.

10:30 Dr Katie Bramall-Stainer says she has been driven from the job she beat 60 other applicants for. ’The job is making me ill and the 31st of this month is the last day in my partnership. This motion is about strength, it’s a clear mandate for GPC and colleagues the time is now to grasp the nettle.’ 

Vote is coming…

10:15 Dr Bill Beeby, deputy chair of the GPC’s clinical subcommittee, says general practice is like being mugged on every street corner. The General Practice Forward View is like the mugger giving you your taxi fare home, but telling you you have to take his brother’s taxi.

But he calls on delegates to vote against industrial action. He says the issues are about having the right funding in the right places. Says he understands emotive appeal to action but its not the right response.

10:10 Londonwide LMCs chief executive Dr Michelle Drage says the General Practice forward view is ’not the rescue practice we demanded’. She calls on delegates to vote in favour of industrial action. ‘This is constructive dismissal’, she concludes.

10:05 The debate on industrial action has started. Most speakers are in favour, so far. Except, notably, Dr Andrew Green, who is clinical and prescribing lead at the GPC, who says that this will be playing into the Government’s hands.

9:30 There have been many passionate speakers so far, mainly criticising the General Practice Forward View. Pulse blogger Dr Shabi Nabi, a GP in Bristol, gets a standing ovation after telling delegates than even her children know there is a crisis in general practice because their mum comes home so later every evening.

9:15 Dr Zoe Norris, a GP in Hull and a Pulse columnist, urges GPs to vote for industrial action.

9:10 At the moment, there is a ’themed debate’ on the General Practice Forward View. The themed debates have been a mixed bag so far – LMC leaders are being allowed to speak more freely, but few decisions are being made.

But this one ends in the big vote – on industrial action.

8:40 Our lead this morning is an exclusive that English GPs are moving to Scotland because of the massive difference in indemnity fees. A GPC negotiator has said that, on moving to England from Scotland, quotes for his indemnity increased by 500%. 

But the big news is set to come up this morning – LMCs will be voting on whether the BMA should ballot GP members on industrial action. Stay on the website for all the latest on that. 

In case you missed any of the action yesterday, here is a run down: