Exclusive: As few as one in four GP practices have committed to taking part in industrial action over pensions on Thursday, a Pulse investigation reveals.
In a blow to the BMA pensions campaign, early figures from trusts across the country suggest a majority of practices have decided not to stop routine appointments and will be open as normal.
It comes as thousands of GPs in London are facing the prospect of having contract payments withheld if they take industrial action, and amid mounting concern over public perception of the protest and the likely additional workload.
Two days before the first industrial action by doctors since 1975, around 22% of practices across the UK have notified their primary care organisation that they will be taking part, with this proportion dropping to one in 10 in some areas.
Figures obtained by Pulse from 20 primary care organisationsshow that 281 out of 1,265 practices have so far notified NHS managers they will be taking action - a disappointing return for the BMA after a ballot in which 79% of GPs who voted backed industrial action.
Both NHS managers and the BMA have asked practices to inform primary care organisations in advance if they plan to take action - and although it is not too late for GPs to notify PCOs, in some areas the majority of practices have already ruled out action. Across Buckinghamshire, Oxfordshire and Suffolk, 134 of the combined 207 practices have confirmed they will remain open.
In Nottinghamshire and Nottingham City, only 28 out of 161 practices said they were taking action. Nottinghamshire LMC chair Dr Greg Place said local GPs were ‘steaming furious' about pensions, but were concerned about workload: ‘We will have to do everything we don't do on Thursday on Wednesday and Friday instead. The only people who will suffer are us.'
In other areas even fewer practices will take part. In Surrey, just 15 out of 129 practices – 12% – have said they will take action.
The figures come after hundreds of practices in London were served with notice that they could be hit with ‘compensation' claims from NHS managers if they are found to be in breach of contract on 21 June.
Pulse revealed last week that a letter sent by PCT clusters to all 1,331 practices in London warned they were obligated to offer a ‘full service' even if they decided to take industrial action.
It said: ‘The local NHS may decide to withhold certain payments due to a contract holder by way of compensation for any breach, should it occur. In addition, formal contract breach notices would be issued.'
Legal experts said this could mean practices facing a ‘termination notice' in extreme cases.
Lynne Abbess, a partner at Hempsons Solicitors, told Pulse: ‘GPs have no in-built right to strike. It would constitute a breach of contract if they only provide urgent care and in a worst-case scenario, it could lead to the end of the contract.'
Dr Chaand Nagpaul, GPC negotiator, said threats of contract sanctions were unwarranted: ‘I think it is unfortunate if PCTs colour requests for factual information with threats.'
Dr Jackie Applebee, a GP in Tower Hamlets, said she was confident the industrial action was not a breach of contract, but warned the threats could dissuade GPs from taking action: ‘I think it will put some people off, especially those who aren't as plugged in to the GP community, such as single-handed practitioners.'
Some GPs in Tower Hamlets are to stage a protest against the Government on the day of industrial action. Dr Kirsten Shirke, a GP In the borough, said: 'All the doctors in our practice are supportive of action. We see the pension reforms as one part of an attack on the NHS. We all feel very angry about these proposals.'
Health secretary Andrew Lansley wrote to the BMA this week to urge GPs taking industrial action to work the following weekend: ‘I would ask your members who are GPs to consider working on Saturday 23 June to clear the backlog of appointments they will have created.'
The idea was quickly rejected by the BMA. A spokesperson said: ‘We do not anticipate the need for additional clinics.'