We had a unanimous decision at the Northern Irish GPC meeting today to ask GPs in Northern Ireland to submit undated resignations. There are a lot of pressures in Northern Ireland and general practice doesn’t seem to be a priority.
Our main concerns are around funding which is at the lowest level of anywhere in the UK at 5.5% of the health budget. We have the lowest workforce in the UK, with 2,000 patients per average whole-time equivalent GP.
And we have the highest workload, which has essentially doubled in the last ten years. So we are in an untenable position. If we don’t step in and fix this now there will not be a GP service, and if there is no GP service there is no NHS.
We’ll take GPs and the service outside the NHS and we will build it back up again
What the Government can do
To stop this happening, we are asking for scheme similar to the GP Forward View and a transformation of the health service in Northern Ireland – most of the resource at present goes to hospital services and given that most of the work has now been shifted into general practice that’s not a sustainable model.
We are looking for a level of funding consistent with the GP Forward View which we think would be about £120 million extra.
We actually have GPs coming to us and saying they want to go forward with dated resignations now, but I think we should give the Department of Health time to come up with a rescue plan. In fact, they do already have a plan which was agreed with us, they just need to fund it.
If they choose not to fund it, we are simply saying that general practice is not sustainable but it would be sustainable if we moved outside the NHS. We will take GPs and the service outside the NHS and we will build it back up again.
The next steps
What we need to do now is go out to the BMA members and explain to them the situation we’re in, the prospect of help in terms of workforce and workload and the options available to us.
The members in Northern Ireland act with solidarity and unity of purpose – when the LMCs explain the situation and advise them that submitting undated resignations is the best way forward, I would be confident that the members will recognise that and work with us as a single group.
We are looking at putting on roadshows to explain the situation to our members between now and Christmas and would expect half the membership to turn up to the roadshows. We will start collecting undated resignations as soon as members want to start sending them to us.
Once we have reached a critical mass of undated resignations (we don’t know what the ‘critical mass’ would be yet, but one suggestion is two-thirds of the membership), we would then move to contract resignations en masse from the NHS. So you are probably looking at giving notice of withdrawing from the NHS within six months.
Dr Tom Black is chair of the Northern Irish GPC