Rarely has the BMA’s annual representative meeting seemed so vital to the specific interests of GPs.
The BMA’s annual shindig sometimes seems a little distant from the nitty gritty of general practice – just a bit too concerned with high-flung politics, and rather too dominated by hospital medicine.
Even this year, general practice is only the specific focus of attention for 35 minutes of next week’s four-day conference. Motions questioning the legal requirement for NHS organisations to break even, and attacking the private-finance initiative, are unlikely to be required viewing for the GP grassroots.
But the difference this year is that the BMA is focusing on a series of issues which are every bit as live to GPs as they are to consultants, and where the votes could have consequences just as profound as those at the LMCs conference, if not more so.
Take pensions, as an obvious starter. There is a motion up for discussion which if anything is more militant than the one the LMCs rejected earlier this month, calling for the BMA to ballot on ‘all forms of industrial action’ if consultants’ final-salary pensions are dumped in favour of a career-average scheme.
General practice is of course already on a career-average scheme, but if consultants did show themselves willing to strike over their final-salary perk, then GPs might just be less willing to accept the pension squeezes heading their way.
And the rumours are that consultants may be willing to do just that, by helping ensure that the motion in question (or to be specific, the relevant section of it) is passed. It is the BMA of course, not the GPC, which runs pensions policy, and a vote to ballot would swing the whole of the medical profession into a much more militant stance.
But it’s not just the pension vote that will hold GPs’ attention next week. There will of course be a substantial focus on the NHS reforms, and the spotlight is bound to fall on the growing tensions between GPs and consultants over who should control commissioning.
The conference agenda, put together before the Government agreed to modify its reforms, showcases the pressure ministers were under to hand a formal role to consultants – with motion after motion demanding secondary care is given a bigger role.
Here too are the seeds of battles to come, with a couple of motions condemning moves to shift care out of hospital and into the community, as lacking an evidence base and risking a destabilisation of secondary care.
But the killer vote may come not on commissioning, but on an issue on which GPs and hospital doctors can stand united.
Delegates will debate a motion warning that the meeting, ‘given the lack of progress in satisfying the requirements for revalidation, does not support the proposed arrangements’.
The BMA has been supportive of the policy of revalidation, even as it has criticised specific aspects of its implementation. But next week could be the moment when it toughens up its act.