The possibility of industrial action if the Government imposed yet another contract on GPs dominated grassroots GPs’ questions to the chair of the GPC in Pulse’s live Q&A, held yesterday.
Dr Chaand Nagpaul was repeatedly quizzed over the GPC’s plans were the Government to impose a contract without agreement from the profession, alongside subjects such as increased workload, the future of the independent contractor status and the care.data programme.
Several GPs posed questions such as, ‘would you consider industrial action if [the secretary of state] takes a unilateral decision on contract change in 2015?’ and, ‘what are you going to do to stop further unilateral erosion of the GP ‘contract’?
Another said: ‘Why does it feel that the BMA always wants to be seen to engage with the Government (and save the NHS)? Is our powder bone dry now or mouldy from lack of use? When are we going to take proper industrial action, and is fee for service not on the table?’
Dr Nagpaul said he was unwilling to speculate on the prospect of industrial action while the GPC was still in negotiations with the Government, but said the decline in GP pay despite increased workloads was ‘grossly unfair’ and he hoped the Government sees that another contract imposition would be ‘a folly’ if it wants to keep GPs on board with the agenda to transform the NHS.
He said: ‘It is grossly unfair that GPs have received pay cuts rather than NHS pay freezes in the last three years, compounded by escalating unpaid workload which has not been recognised by Government.’
‘I hope the Government will see the folly of a contract imposition, given that its entire agenda to manage NHS costs, develop CCGs and move care into the community depends upon GPs. The government needs GPs to be on board to deliver a sustainable NHS,’ he added.
He added that the GPC is ‘presenting a robust case to the DDRB so that GPs are remunerated fairly, as well as recognising that they are working harder than ever before. Unless this is addressed, we run the risk of general practice not attracting and retaining GPs.’
Several GPs also asked about the GPC’s view on the future of independent contractor status, in the wake of outgoing RCGP chair Professor Clare Gerada’s comments that the model ‘is outdated’ and should be dropped.
Dr Michelle Drage, chair of Londonwide LMCs, which has launched a survey of members over the issue, asked: ‘In London, where Clare Gerada now has an NHS England role as chair of their clinical board for transformation of general practice, and where Ara Darzi has now been appointed by the mayor to review primary care, how does it help either partner GPs or salaried GPs looking for careers in partnerships (as most tell us they want) to throw balls into the air like salaried service and the end of ICS?’
Dr Nagpaul said the GPC would defend GPs’ independent status and that it was a ‘bargain’ for the NHS.
He added: ‘We need a concerted effort between the GPC and Londonwide LMCs to argue for the clear benefits of independent contractor status and we also need to positively engage GPs who wish to become partners. The partnership model underpins the success of UK general practice.’
‘I do not agree nor believe that GPs as a profession will become salaried. The independent contractor status is a bargain for the NHS, costing just over £100 per patient for a year’s unlimited care. However, we believe in contractual options for GPs and those that wish to be salaried should be able too under fair terms, conditions and pay.’
On the issue on the care.data programme, which gives GPs eight weeks to inform patients that data is to be extracted from their records, Dr Nagpaul said: ‘The issue about care data is that the majority of the public are oblivious that their data will be uploaded nationally. We are putting pressure on NHS England that there must be a widespread publicity awareness campaign that allows patients to object to their data being uploaded should they wish to.’
And Dr Nagpaul said the GPC was committed to fighting for longer consultation times and cutting back on ‘tick box’ exercises that takes GPs away from patient-centred care.
He said: ‘We are pressing the government to remove large areas of QOF that provide no benefit, or even damage care, and to give GPs the resources that they need to meet the core needs of their patients.’