Exclusive LMC leaders in England are looking at potentially taking GPs out of the NHS, which could even involve charging patients directly for some GP services, Pulse has learned.
Pulse has learnt that English LMCs are considering breaking off from the GPC due to disillusionment with the national negotiators and setting up a ‘National Association of LMCs’.
They are following the lead of the Northern Irish GPC, which is currently developing a ‘Plan B’ in preparation for a mass resignation of GPs.
Pulse understands that the Northern Ireland document is looking at potentially charging patients, basing it on the Republic of Ireland model, where practices set their own fees for patients.
The GPC in England called off plans in August to ballot members on potentially submitting undated resignations or industrial action after claiming that it has won concessions on workload from NHS England.
But the Northern Irish GPC is to press ahead with plans for a mass resignation, which is being supported by grassroots GPs with a meeting earlier this week in Belfast drawing 200 GP attendees, 97% of whom supported the plans.
Pulse has learned that Northern Irish GPC chair Dr Tom Black has already drawn up a 27-page ‘plan B’ modelled on general practice in the Republic of Ireland.
Dr Black told Pulse: ‘I think that I would rather have a contract directly with the population than with the Government.
‘We already have a situation here in Northern Ireland that one mile as the crow flies from where I am sitting, patients pay to see their GP. We already have a model in the Republic of Ireland that works very well and gets morbidity and mortality statistics which are consistently better than in Northern Ireland.’
LMCs in England are currently considering drawing up ‘Plan Bs’, following the lead of Northern Ireland, Pulse has learnt.
Oxfordshire LMC chair Dr Prit Buttar is preparing a report for Berkshire, Buckinghamshire and Oxfordshire LMCs (BBOLMCs) on a range of radical alternative options for GP practices in the region after criticising ‘GPC representation and protection of general practice’.
He said that the LMC was considering ‘everything from one extreme to the other’.
Dr Buttar said the LMC was looking at ‘the economics, and the financial reality of what life outside the NHS would look like. How practical is it? How affordable is it? What are the likely consequences for practices and their patients?’
He added: ‘At one extreme, currently the situation is that you bill patients for HGV medicals and stuff like that, while the state pays for everything else.
‘The other extreme is you walk away from your GMS PMS contract and set up privately.’ He added that there were lots of ‘shades of grey’ between.
Dr Buttar added that they were not the only LMC in England looking at drawing up a plan B for their GPs.
He said: ‘There is a general mood of, I suppose, a mixture of resignation and frustration that people need to start looking at alternatives. There is more than one area of the country looking at this, and what can and cannot be done.
The LMCs have also revealed that they are looking at the potential of paying GP levies towards a ‘National Association of LMCs’ rather than GPC in future.
Dr Paul Roblin, chief executive of BBOLMCs, told Pulse that ‘at the moment we’re not particularly impressed with what the GPC is doing to make general practice a more desirable profession to enter’.
But he admitted that the idea of a plan B ‘wasn’t universally received in Oxfordshire, because people felt their livelihoods were entwined with the NHS model’ and that ‘to extract themselves from that would be personal, financial lunacy’.
A BMA spokesperson said: ‘The BMA GPs committee is totally committed to supporting and working with LMCs in representing all GPs across the UK. That is why we have completed a major review of the structure and function of GPC to enable closer working with, and optimal partnership with LMCs.
‘We have been robust in our negotiations with government, and have been consistently outspoken in challenging flawed political policy such as routine seven day opening. We therefore do not recognise the unsubstantiated description of GPC’s approach as described in the comments of one representative at a recent Oxford meeting, and we do not believe this is reflective of the constructive working relationships GPC has with the overwhelming majority of LMCs.’