No GP collective action planned until next Spring, says BMA GP leader
Exclusive The BMA is not going to push for GP collective action before next Spring, the leader of English GPs has said.
In a message to GP leaders, seen by Pulse, BMA GP committee England chair Dr Katie Bramall said that there is an intention of starting ‘activity’ in the Spring, should a contract imposition happen from 1 April.
It comes after Dr Bramall said last month that there were ‘no current plans’ to ballot England’s GP members in the ongoing dispute with the Government over online access changes.
At the time, LMC leaders questioned whether the suggestion that no ballot is imminent was against BMA policy, as GP leaders recently demanded ‘a clear timeline’ for a ballot of the profession, as well as backing new forms of collective action, including full-day walkouts.
However, last week the GPCE voted against an urgent ballot on industrial action, but in favour of calling on the Government to meet with it ‘urgently’ to discuss ‘terms of a reset in the relationship’, so that ‘further escalation can be avoided’, following a breakdown in their relationship.
Now Dr Bramall has confirmed there are no plans for collective action before the Spring.
Dr Bramall’s message to GP leaders said: ‘Start and end times matter, as whilst we can undertake collective action whenever we need to, we will garner more numbers if we set advance starting pistols as we know not all LMCs are in a position to do heavy lifting locally. Some weren’t able to even forward the online consultation survey!
‘This is necessarily going to take time. We would be wise to start outward facing work in the new year, with an intention of landing results and activity in the Spring, were we to assume a contract imposition from 1 April.’
Pulse has contacted the BMA for comment.
Pulse also understands that Dr Ivan Camphor, who represented Cheshire and Mid Mersey on the GPC, has resigned from his position citing the committee’s decision not to proceed with preparations for a ballot as one of the reasons he decided to step away from his role.
In a letter to Dr Bramall, seen by Pulse, Dr Camphor said: ‘The decision not to proceed with preparations for a ballot of the profession in the new year, despite the strength of feeling and clear direction expressed at LMC conference, has further undermined my confidence that the committee is responding to the mandate given to it.
‘At a time when general practice is under unprecedented pressure, I believe my energy and time are best directed towards patient care and local advocacy, rather than internal politics in which I no longer have confidence. For these reasons, my position on this committee has become untenable.
‘I remain committed to advocating for general practice and for my colleagues, but I can no longer do so as part of GPC England.’
As exclusively revealed by Pulse, instead of GP contract negotiations with the GPC for 2026/27, the Government will ‘consult’ it alongside a wider group of stakeholders, including the RCGP and patient groups.
Pulse has recently looked into the reasons and timeline of the breakdown in relationship between the BMA and the Government.
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Ben Gowland view interesting
Why the BMA Losing Exclusivity will Damage General Practice
Posted by Ben GowlandBlogs, The General Practice BlogNo Comments
I have been surprised by the relatively limited reaction there has been in many quarters to the government’s announcement that it will no longer be negotiating the GP contract solely with the GPC. I can only see the consequences of such a move as being deeply damaging for GP practices.
It has been made claimed that the GPC has acted unreasonably and it is as a result of this the government wants to “widen the consultation” on the GP contract. Secretary of State Wes Streeting wrote to all practices and made a personal attack on GPC Chair Dr Katie Bramall-Stainer, claiming her actions were “deeply unprofessional and unbecoming of a professional representative body”.
Has this incarnation of the GPC acted unreasonably? While the government find it easy to forget, practices will recall that Dr Bramall-Stainer inherited a position of multiple years of imposed contracts at below inflation levels of funding. Despite the financial challenge the new government then created for practices with the huge employer NI contribution and the 4% pay awards for staff, she managed to get agreement from the profession to a contract that was only just about acceptable and did little if anything to address the underfunding of the previous years.
There was even talk of a vote of no confidence in her at the LMC conference in September, although happily this never materialised, but it shows the tightrope she is having to walk. The government’s refusal to put in place the promised safeguards before insisting upon online access throughout core hours was a step too far for the profession, hence the response.
The GPC has not acted unreasonably. On the contrary, it has worked hard to try and find agreements in what are undoubtedly extremely testing circumstances for practices. So if the GPC is not being unreasonable, what is the problem?
The origins of the current issue can be traced back to a period before this government. After Covid and the departure of Nikki Kanani there was a marked shift in approach by NHS England towards general practice. This shift was away from working in partnership and towards using the contract as a tool by which to control the profession and make it comply with national wishes.
At first the contract agreed in 2019 was used as a mechanism to ensure real terms funding cuts were endured by general practice. Starting in 2022 NHS England simply refused to agree any uplifts despite inflation running as high as 10% and instead imposed a contract agreed when inflation was 2%. Emboldened by the success of this approach, NHS England has since used the contract as a lever to enforce changes to access to practices.
In 2023 the (then Conservative) government took the highly unusual step of laying legislation before parliament to change the core GMS contract, stipulating how practices need to respond to contacts made by patients, most likely on the advice of NHS England. This year they included the requirement of practices to open online access during core hours in the contract, something they are adamant they will not back down on.
The GPC has no choice but to push back against this increasingly directive and contractual approach. If it did not, it would not be doing its job. This is not the GPC being unreasonable. It is the profession refusing to be bullied.
The response of the government is that it will no longer solely consult with the GPC (it is noteworthy that the government no longer “negotiates” contracts, but instead “consults” on them). It will now also consult with the RCGP, the National Association of Primary Care (NAPC), Healthwatch England, National Voices and the NHS Confederation.
The contract changes that will be proposed will almost certainly be unpalatable to practices, and therefore to the GPC. However, the government and NHS England will be able to gain more support for these changes by seeking feedback from a wider range of stakeholders, the majority of whom will not directly suffer as a result of the proposals.
There is no doubt in my mind that this move is extremely bad for general practice. It is a deliberate misdirection by NHS England and the government to claim that this is a result of the behaviour of the GPC. It is not. It is a move to continue the move towards more contractual control and to establish even more radical changes into the contract, by weakening the ability of the profession to prevent or even ameliorate them.
The “tightrope” being delicately walked should long ago have been the Rubicon crossed….
Action delayed….and delayed again and again…..is, ummm, Inaction and collusion.
Good luck, all Hippocratic-oath taking patient advocates. “Primum non nocere” but instead let the Govt do the harm to our patients with their falsehoods about funding, money, interests, and for blaming GPs for the state of the NHS.
Eg I’m surprised the public has no idea about GP unemployment at the same time as huge patient demand. Well done to the BMA for keeping all these things secret 🙄
Never regret stopping the subs let down after let down.