BMA votes to support GP contract dispute over 10-year plan

Doctor leaders have voted in support of GPs re-entering into formal dispute with the Government over the risks to the independent contractor model and GMS contract presented by the 10-year plan.

At a ‘special representative meeting’ (SRM) held remotely yesterday (14 September), BMA leaders passed a motion backing GP dispute – unless ‘sufficient legislative safeguards’ were introduced to protect the GMS contract and partnership model. 

The motion also demanded that no general practice contracts beyond those already held by trusts be permitted to be transferred to trusts; and that GP practices receive full resource restoration with the necessary accompanying pay restoration, to levels ‘commensurate in real terms to 2004 GMS’.

Health secretary Wes Streeting, who attended the meeting via video link, said that the Government is looking for GPs to ‘step up’ and lead the new neighbourhood health service – though this came against the backdrop of a new BMA survey which revealed that 89% of GPs believe the 10-year plan will lead to the decrease of autonomy for general practice.

During his address he urged the union to work with the Government, warning that the consequences of not doing so could pave the way for Nigel Farage’s Reform Party.

The health secretary’s words did not appear to go down well with doctors speaking later during the SRM, nor assuage their fear over his commitment to the independent contractor model and the GMS contract.

Proposing the motion, deputy chair of the Conference of England LMCs and BMA Council member Dr Paul Evans said: ‘We have already heard the empty words of the secretary of state for health and social care, Mr Streeting, and some of those words were untrue. 

‘Some were blaming GPs for current problems, and some were threatening GPs. Indeed, I believe we were threatened with a prospective Reform Government being on us if we oppose this plan. If that’s true. Mr. Streeting, then shame on you.’

Dr Evans accused the health secretary of not guaranteeing the survival of the GMS contract: ‘It is weasel words for now on GMS. GMS remains ‘for now’ – not in perpetuity, as it has always been – but ‘for now’.

‘In theatre, if in the first act you introduce a revolver, it must be used by the end of the third act. You wouldn’t introduce those words if you did not mean them to be used.

‘Mr Streeting today told us everything we need to know in his speech and responses. We need to go into dispute.’

Speaking for the motion, Liverpool GP Dr Annie Farrell warned against what she had observed in practices that had moved to the totally online triage system that was advocated in the 10-year plan.

She said: ‘Practices with this system in place completely move away from what I would consider to be general practice. The new game is reviewing online requests and ensuring that as many of them as possible are batted away to non-GPs or “Right Care, Right Time”.’ 

She added that she had seen multiple examples of practices in Liverpool operating under alternative contract providers fail over the years, with several closing, and some being ultimately taken over by individual GMS practices. 

‘If these private organisations couldn’t make these practices work, what on earth makes anyone think that a hospital trust with their debts and ability to close services could take this on? 

‘It’s clear from this morning’s [the health secretary’s] speech, that the Government has absolutely no idea how significant the GMS contract is to the provision of high quality general practice, and that GMS is the family doctor.’

There were calls from some members to reject the motion’s call for the BMA to ‘condemn and oppose’ the 10-year plan in its current form, saying that to do so would be ‘throwing the baby out with the bathwater’ and would risk politicians dismissing doctors as ‘unserious’ about change. These concerns were dismissed, and all parts of the motion passed.

This comes after Pulse exclusively revealed last week that several local medical committees (LMCs) were asking the BMA’s GP Committee England to enter a contract dispute with the Government over new access requirements from 1 October.

At yesterday’s SRM, Mr Streeting took questions from BMA council chair Dr Tom Dolphin (prior to the motion being passed) over these changes, and whether he would engage with GPC to avoid a dispute with the profession.

Mr Streeting disagreed that the changes on keeping online systems, telephones and doors open through core hours were being ‘imposed’ upon GPs; adding that although they are achievable and unavoidable, ‘some GPs’ just don’t ‘like’ them. But he said he was still ‘happy to work with GPC’ to avoid dispute.