The GPC in Northern Ireland is today set to vote on whether to collect resignations from GPs, which could see GPs leaving the NHS and charging patients for their care.
The meeting today is set to ratify the action, which is one of the most radical measures ever proposed by GP leaders in the UK, in response to the ‘collapse’ of general practice in Northern Ireland, Northern Ireland GPC chair Tom Black said.
The move, which would see GPs leave the NHS and start to charge around £45 for appointments, was supported by 97% of BMA members who attended a series of meetings at the end of 2016.
In an exclusive interview with Pulse, Dr Black said he ‘couldn’t see any circumstances in which we would not start collecting practice resignation from 25 January.’
There had been hope such action could be avoided with the agreement of a ‘rescue plan’ similar to the GP Forward View but Dr Black said the collapse of the power-sharing government in Northern Ireland has left GPs in the country with no alternative.
Once the decision is taken by the GPC, the moment at which GPs walk away depends on how quickly they reach ‘critical mass’.
He said: ‘The problem arises really if, say, 100% of practices in one county puts in resignations, do we wait til the rest of Northern Ireland is ready to catch up?
‘I think that county would make a decision to go private – to step outside the NHS – and I think we’d have to support them with the lawyers, the accountants even the estate agents, because some practices would be in health centres and they may not be allowed to continue in it. We have a significant defence fund of £600,000-700,000 in that.’
GPs opting to go privately would mean a likely £45 consultation fee for patients – similar to the system in Ireland – with one scenario being the Government spending the £240m currently spent on GPs to reimburse patients ‘for fee-per-item consultations’.
Dr Black said that it is likely patients will go to A&E, overwhelming hospitals, because they don’t want to pay and unless a solution is found, the whole NHS is in jeopardy.
He said: ‘There is a view in BMA House that we’re falling into a trap – that the politicians want us to go private, and they want it to be our decision and not theirs.
‘Maybe we are. But I don’t have a choice here, because if we stay inside the NHS with the funding levels and the workforce levels, we won’t have a GP service.’
The action has been proposed in response to the ‘collapse’ of general practice in Northern Ireland, Dr Black said.
‘Some areas are collapsing faster than others – Fermanagh and Armagh are collapsing rapidly,’ said Dr Black.
Dr Black has predicted that at least 20 surgeries face closure within the year due to lack of investment, severe staff shortages and unmanageable workload.
In Portadown, there have been fears that the whole town could lose its GP services after a practice lost all its staff in a period of weeks and a replacement contractor pulled out.
With remaining practices already having more than 2,000 patients per GP there is no give in the system, he said.
The RCGP has already called on politicians to work together to ‘save’ general practice.