Northern Ireland’s GP Committee will ‘fully explore’ whether industrial action is an option for GP partners, following a vote at this weekend’s LMC conference.
On Saturday, representatives from the country’s local medical committees passed a motion on industrial action at their annual conference in Belfast.
The motion said they are ‘appalled’ by the Department of Health’s ‘inaction’ to address pressures facing GPs.
In his opening speech, Northern Ireland’s GPC chair Dr Alan Stout told LMC members that general practice is now in the most difficult position it has ever faced, and that the lack of political and local accountability is ‘utterly disgraceful’.
In a recent exclusive interview with Pulse, Dr Stout said GPs across the country could walk away from their NHS contract and come up with an ‘alternative option’ if the problems facing the profession are not solved.
He revealed that the BMA has an ‘options paper’ to assess potential actions, and one of them is to ‘simply leave the current contract’.
As well as the successful vote on exploring industrial action, the LMC conference also passed a motion instructing NIGPC to demand ‘immediate engagement’ with the Department of Health (DoH) on negotiation of a GMS contract for 2024.
Representatives passed a motion on enhanced services, instructing the GP committee to do a full review of the cost of each service and to make the ‘inappropriate use of non-recurrent funding’ a red line in any negotiations.
Another successful motion condemned ‘the reduction of funding in year of GP federation elective care services’ and instructed the NIGPC to open negotiations with the DoH to restore this funding.
The motion focused in particular on the decommissioning of women’s health and vasectomy services, directing the GP committee to ask DoH whether an equality impact assessment was carried for this decision.
The conference on Saturday followed news that another GP practice in Northern Ireland has handed back its contract, with the partners saying they cannot provide a ‘safe, sustainable service’ due to a ‘lack of adequate medical cover’.
This means 19 practices have now handed back their contract since July last year, and during that time the country has been without a first or deputy first ministers, with civil servants only permitted to make decisions that follow policy previously set by ministers.
Dr Alan Stout told representatives at the conference: ‘Let me be absolutely clear, the crisis is not the fault of the hard working, committed GPs and it is not the fault of our LMC or other GP representatives.
‘We have and we continue to lobby, to advise and to warn of the problems we face and the problems that are coming rapidly at us, but we see so little to help us or to even give us some hope.’
He said that for healthcare to work, GPs and other NHS staff in Northern Ireland ‘need local government, a health minister and local and multiyear budgets’.
‘Without local, public accountability we see doctors and staff being held accountable time and again for things that are totally out of their control, and this is simply unacceptable,’ Dr Stout said.
The BMA has repeatedly called for actions to reverse the crisis, and in August published its ‘plan to save general practice’, which said they are ‘seeing an unsafe service in every area’ of Northern Ireland.
The plan included priorities such as securing an indemnity solution for GPs, who unlike GPs in England and Wales do not have state-backed indemnity, as well as continuing the QOF freeze with a view to eventually abolishing it.
In his speech on Saturday, Dr Stout said the GPC has ‘seen no movement on any of these key actions’, which led to GPC members voting in favour of a major renegotiation of the GP contract for next year, outside the normal cycle of talks.
Highlight motions in full
AGENDA COMMITTEE to be presented by NORTHERN LMC: That conference has no confidence in the commissioning processes for health care in Northern Ireland and:
(i) demands urgent review and reform to ensure an increase in the resources available for general practice PASSED
(ii) instructs NIGPC to demand immediate engagement with the Department of Health regarding a new GMS contract for 2024 to ensure the continued existence of general practice. PASSED
SOUTHERN LMC: That conference is appalled by the inaction of DoH in addressing the worsening pressures facing primary care and instructs NIGPC to fully explore if taking industrial action is an option for GP partners. PASSED
AGENDA COMMITTEE to be proposed by SOUTHERN LMC: That conference instructs NIGPC to undertake a full review of the cost of provision of each enhanced service and demands that the inappropriate use of non-recurrent funding is a red line for NIGPC in negotiating any service for primary care. PASSED
EASTERN LMC: That conference calls for an item of service fee for all vaccinations given outside of the agreed vaccination programmes. PASSED
SOUTHERN LMC: That conference instructs NIGPC to negotiate a change to the childhood immunisation payment process with DOH to remove the continuing unfair impact of vaccine hesitancy on practice income. PASSED
SOUTERN LMC: That conference notes with dismay the continued focus of DoH on proceeding with an NHS111 type service and instructs NIGPC to reject any request for direct access to GP appointments by outside organisations. PASSED
NORTHERN LMC: That conference demands that NIGPC ask the Department of Health why there has to be a “tangible economic benefit” to sorting the indemnity issue for GPs in Northern Ireland when there is little or no cost and obvious clinical benefit. PASSED
AGENDA COMMITTEE to be proposed by NLMC: That conference condemns completely the reduction of funding in year of GP federation elective care services threatening the viability of GP elective care services and directs NIGPC:
(i) to open negotiations with the Department of Health and SPPG regarding a restoration of the funding for elective care PASSED
(ii) to ask DoH specifically whether a section 75 Equality Impact Assessment was done on the gender effect of the decision to decommission women’s health and vasectomy services and where within the NHS will be providing these services after April 2024. PASSED