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LMC leaders duck the big questions

The Scottish LMCs conference left some key issues unresolved, writes PulseToday editor Steve Nowottny

To be honest, last week's Scottish LMCs conference was a little bit of a disappointment.

Not in terms of the event itself, of course. The Scots are welcoming hosts, it's a well-organised gathering and always a convivial affair. The conference has been running in the same venue, the Beardmore Conference Centre in Clydebank, just outside of Glasgow, for several years now, and they've got the whole process down pat.

But from a medico-political journalist's point of view? It was a bit of a let down.

In previous years, the conference, which always takes place around this time of year, has proved a decent guide to the year ahead, particularly to the UK LMCs conference, which always take place in June.

There are some key differences, of course - private sector provision, for example, simply isn't an issue for GPs north of the border, given the Scottish Government's sympathetic stance on the issue. But in general, it's been possible to get a reasonable idea of the way the wind's blowing on the really big issues likely to affect the profession.

Last Thursday, not so much.

Out-of-hours was the big one, of course. Although taking back responsibility for out-of-hours care is less immediately likely in Scotland than in England, where it's a central plank of the Conservatives' health policy, the debate was expected to act as a useful barometer for the profession's opinion. But despite a useful and spirited discussion, with speakers split more or less evenly, a decision one way or the other never came. Delegates decided the ambiguous wording of the motion meant they couldn't vote on it at all.

It was, as GPC Scotland chair Dr Dean Marshall put it, 'unfortunate' - but it wasn't the only time delegates seemed to duck the key questions.

A motion calling on the Scottish GPC to 'propose solutions to the problems that have arisen since the introduction of the current GP contract and led to GPs being reluctant to offer partnerships to their colleagues' received enthusiastic and eloquent support - but concrete suggestions as to what those solutions might actually be didn't really materialise.

Four parts of a five-part motion calling for a 'proportionate' approach to revalidation were carried, including a demand that 'all costs of revalidation are met centrally'. But the fifth and key part - asking that 'the costs of remediation are met centrally and do not penalise any individual doctor' - was voted for only 'as a reference', meaning it won't become official policy, again on the grounds that it was poorly worded.

And what of the Government's far-reaching plan to scrap practice boundaries? Well, there were two relevant motions due to be discussed, one highlighting the impact on continuity of care, the other warning of the 'far-reaching negative consequences' of dual registration. But, unfortunately, neither was ever debated. They weren't high up on the agenda, and delegates simply ran out of time.

None of this means that the conference wasn't a useful one, of course. It was as ever a good forum for LMC members from across the country to exchange views, and there were some strong debates on important issues - the patient survey, sharing of patient records, the marginalisation of GPs from antenatal care and dispensing doctors, to name a few.

But it does mean that we're still much less sure than we might be of where the profession stands on some of the biggest developments likely to hit primary care in the next twelve months.

There's an election first, of course. But after that, all eyes will be on the UK LMCs conference in June.

Where, hopefully, we'll get some answers.

Steve Nowottny