The BMA’s GP Committee now believes PCNs pose an ‘existential threat’ to the independent contractor model.
GP representatives attending an England LMCs’ conference in 2020 had voted in favour of a similar motion, meaning this should have already represented GPC policy for the last two years.
At a quarterly GPC England meeting last week, representatives voted in favour of a motion that said the committee ‘reaffirms’ this.
But Pulse understands this is the first time the GPC has actively voted for the policy.
The motion said the committee ‘reaffirms the belief (as also expressed by Conference) that PCNs pose an existential threat to the independent contractor model’.
Pulse understands it was passed by only seven votes – with 27 GPC members voting in favour, 20 voting against and seven abstaining.
Another part of the motion – which was also passed – reaffirmed the GPC’s ‘commitments’ to the independent contractor model as a whole, saying the committee ‘renews its efforts to supporting the model’.
And the GPC also voted to ‘[reject] NHS England’s approach in replacing general practice with a one-size model all-salaried service’.
BMA England GPC chair Dr Farah Jameel said: ‘General practice has evolved over many years, changing to meet the needs of communities, but with the independent contractor model sustaining as the core on which it is built.
‘We know that patients appear to benefit from continuity of care, with the quality, strength and consistency of their relationship with their family doctor having a significant impact on their health outcomes. All of this and more is possible through the independent contractor model.’
She added: ‘The outcome of this motion reaffirms the committee’s wholehearted support and commitment to this model that allows for high-quality, cost effective and timely care, despite it being poorly valued by policymakers.
‘And it further demonstrates how important it is that the profession stands together with strong representation for all GPs, regardless of career path, at a time when general practice and the whole of the NHS and care system are facing unprecedented challenges.
However, although the committee voted to recognise that GP contractors’ working conditions are ‘deteriorating’, a part of the motion calling for a change to BMA rules to allow the formation of a separate GP partners’ committee was not passed.
In March 2020, GP leaders at a special LMC conference voted to reject the primary care network DES that was agreed as part of the 2020/21 GP contract in England.
The 2020 motion said that the conference ‘believes the PCN DES is a Trojan horse to transfer work from secondary care to primary care and that… this strategy poses an existential threat to the independent contractor model’.
It comes as a major Pulse survey has revealed the extent of the GP partnership crisis, with 40% of partners considering taking salaried roles.
The findings come amid an ongoing shift towards sessional work among GPs – with around half of the workforce now made up salaried and locum GPs.
Earlier this year, it was reported that health secretary Sajid Javid was looking to roll out the ‘Wolverhampton model’ – which sees GP practices taken over and run by a hospital trust – across England.
And in March, a report by think tank Policy Exchange and backed by the health secretary recommended that the GMS contract be phased out by 2030 and most GPs be contracted by scaled providers such as hospital trusts.
GPC motion in full
That this committee:
(i) Reaffirms its commitments to the GP independent contractor model and renews its efforts to supporting the model. PASSED
(ii) Recognises the deteriorating working conditions of GP contractors throughout the country. PASSED
(iii) Will pursue a change to BMA articles and bylaws to allow the formation of a separate GP contract-holders committee. FELL
(iv) Rejects NHS England’s approach in replacing General Practice with a one-size model all-salaried service. PASSED
(v) Reaffirms the belief (as also expressed by Conference) that PCNs pose an existential threat to the independent contractor model. PASSED
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