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Politicians urged to take immediate action to avoid GPs leaving NHS

The Review Body on Doctors’ and Dentists’ Remuneration has urged the Northern Ireland Executive to take steps to ensure general practice is not ‘irrevocably damaged’ in a stark warning in its annual review of doctors pay.

GPs in Northern Ireland are ‘extremely discontented’ and while there is temporary reassurance that a primary care strategy is written and ready to go the suspension of the Government has put everything on hold, the DDRB said.

After pointing to the to the BMA’s move to collect undated resignations after 97% of GPs voted to step away from the health service, the DDRB described the situation as ‘particularly precarious’.

‘It could be potentially very serious for healthcare delivery if the resignations were submitted, and we urge the Northern Ireland Executive to take steps to ensure primary care delivery is not irrevocably damaged,’ the DDRB said.

The DDRB also warned of the problem of ‘last-man standing’ in Wales where there had been a trend towards GMPs ‘handing back the keys’ in rural areas, which, coupled with recruitment problems could hamper primary care delivery ‘in the near future’.

The NHS in Northern Ireland is on a knife-edge amid political standstill after power-sharing talks broke down.

In the meantime the general practice rescue package that was agreed in December cannot be implemented because the civil servants left in charge have no budget to work with.

‘There is an absolute degree of urgency and the health service is falling apart around us in all aspects,’ said Dr Alan Stout, deputy Northern Ireland GPC chair who added he was not at all confident there would be a solution any time soon.

He added that only 90% of the budget from last year can be carried over in the current stalemate so the situation was about to get even worse.

‘This is why we are collecting the undated resignations. If there is nobody there to solve it for us rather than an uncontrolled collapse we have to try and preserve and protect something.’

After receiving ‘overwhelming support’ when the plan was voted on, GPC NI began collecting resignations this year and say they will submit them once 60% of practices opt-in.

However, despite its warnings, the DDRB recommended just a 1% – below inflation – pay uplift for all UK doctors, which was accepted by health secretary Jeremy Hunt.

Northern Ireland’s ‘plan B’

The GPC in Northern Ireland devised its ‘plan B’ to take GP practices out of the NHS after failing to get the Government to address issues facing general practice.

At the time, NI GPC chair Dr Tom Black said that the situation was worse than in England, with Northern Irish GPs not even having a GP Forward View rescue deal to turn to.

Since then, the GPC has received the backing of plan B from grassroots GPs in Northern Ireland, and 25 January was set as a deadline to reach a rescue deal with the Department of Health.

So what is the GPC’s plan B?

It is looking at the model in the Republic of Ireland, where there are two types of patients. The first is those with a medical card who are seen in general practice without charge – this is dependent on income and covers around 40% of the population. But those without a card pay a charge of €45 to €55 for each consultation.