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A striking lack of enthusiasm

A striking lack of enthusiasm

Dr Copperfield can’t get on board with the calls for industrial action

I fear I may be seriously out of tune with the current chorus of GP contractual disapproval here, but then again I’m old, grumpy and generally unimpressed with everything. The thing is, I’m just not feeling this industrial action sentiment which is assumed to be sweeping the nation’s GPs.

I’m not even sure, if I were to take strike action, specifically what I would be taking strike action against. The ongoing erosion of pay? The ever-expanding workload? The imposition of the contract (again)? The general shittiness of everything? The fact that everyone else has a had a turn at striking? OK, yes, it’s probably all about the derisory pay offer but then again, an ‘as-you-were’ interim contract offer was almost inevitable given a likely change in government, and was predicted by our editor a while back.

Then there’s the form that industrial action might take. Shutting up shop would be impactful but has all sorts of contractual/medicolegal/ethical bananaskins and has already been ruled out by GPCE. As for the bunch of potential other ‘work to rule’/’screw the NHS/’bust the budgets’/’create havoc’ ideas: frankly they’re all slow impact, low impact or no impact and would generate absolutely zero media coverage.

Plus, of course, there’s the fact that many of us have seen all this supposed militancy before and even when the anger is more focused, it all ends up a bit of a damp squib or even fizzles out before reaching that point – not least because we’re dealing with professionals with varied attitudes and more than one mode of employment. And if there’s one thing that’s worse than no industrial action, it’s a promise of industrial action that doesn’t materialise.

Which explains why I have no great acute militant urge, just an ongoing chronic grumpiness. And given the context of a likely change in government, all the barricade and banner drum-banging sounds a bit hollow.

More radical, perhaps, to do the opposite: an anti-strike. Instead of actually or metaphorically shutting up shop, open the surgery doors for a weekend to see what we can do for those clogged in the secondary care system. Making manifest the hours GP waste in doing this already would at least be good PR.

Or if you fancy something harder hitting, how about an evening projecting onto the Houses of Parliament the images of those who’ve died on waiting lists. Because the one issue we’re all genuinely angry about is the broken NHS and the lack of political guts to provide a radical overhaul. Now you’re talking. Keep your banner but pass me that projector.

Dr Tony Copperfield is a GP in Essex 



Please note, only GPs are permitted to add comments to articles

Jonathan Heatley 11 March, 2024 6:19 pm

we could start by refusing to do QOF, CQC and appraisals and mandatory training and sell it by saying we will use the freed up time to see patients. The stuff we are stopping does not help us, the patients or the NHS so lets have the common will and courage to refuse it all.

Dave Haddock 11 March, 2024 6:40 pm

Should have refused to do Appraisals or co-operate with the CQC years ago.
BMA are utterly useless.

David Church 11 March, 2024 6:53 pm

It is a pity there are not any bills we could delay paying – since they just deduct them anyway before paying us !
We could discontinue sending of reports and statistics, and paper notes packets, to NHS HQs; disengage with CQC and appraisal; and turn off external access to our records – but I think that could be worked around since we no longer control access to our own data now!
What about disengaging from going to ICB meetings?
switching off scriptswitch?

David Jenner 11 March, 2024 6:55 pm

Well David , being one of the only NHS staff groups not to strike and the only part of the NHS to improve productivity and not give the government a deficit has not exactly been recognised and rewarded has it ?
Consultants have got a better deal through striking but unless we show unity and determination we won’t get anything .
Maybe DDRB will see the facts and recommend a decent contract uplift , but will the government fund it ?
We do see a big proportion of the population every week so getting our position across even more important than industrial action but you have to be prepared for that as well. !

Syed Zaffar 11 March, 2024 6:57 pm

I agree with Dr Copperfield with regards to lack of clear objectives and with J Heatley & D Haddock. for their views …..the civil service & bureaucracy are running the PHC into the ground. GPs could have taken the pressure off the NHS if utilised properly and bureaucracy giving clear direction on prioritising objectives … !

So the bird flew away 11 March, 2024 9:29 pm

Blimey, couldn’t conjure up some laughs this week TC? Feeling ground down?
Methinks, time to retire to oyster-picking at Goldhanger estuary. They’re lovely. Is that somewhere near you?

Jane Hargest 11 March, 2024 10:47 pm

I’m with Dr C. Realistically we’ll get nothing out of this government with an election looming. It’s the NHS that needs to be fixed. One day it may be you on a wait list. Projecting images on the Houses of Parliament sounds like a pretty good idea.

Just My Opinion 11 March, 2024 10:54 pm

Refuse QOF?
A voluntary activity anyway, of which the only effect will be you lose income?
Please, explain how in any way that will advance our cause?

Dylan Summers 12 March, 2024 8:16 am

Jaimie K writes a good column on this this week. The basic problem is: how can a contractor strike? All a contractor can do is refuse to take on a contract. And clearly we aren’t going to decline to take on our main contract.

As a salaried GP, I personally wonder if this is an argument in favour of moving to an entirely salaried service. If all GPs were employees, we could strike. But I don’t expect everyone to see it like that.

Richard Greenway 12 March, 2024 8:57 am

Copperfield you are usually completely on the money, but this time I totally disagree. GP Partners have been completely stitched up. Round here, partners and leaving in their droves, and no-one wants to be one. Who would vote for a 15%-20% paycut for themselves with another to follow next year. However, without Partners-no staff are employed. Who would be the CQC managers ? The lead roles? Whose name are the surgery loans in? Who supervises ARR roles? Employs the salaried GPs and locums? The stitch up is numerical – National minimum wage is up 50% over 5 years. Our baseline up a measly 1-2% per year -which doesn’t even cover all staff salaries. QOF is cunningly ‘increased’ at the same rate that practice list sizesgo up (due to closures/ mergers) so no money. Local LES have been cut 20-30% for some.

There are some older partners who comfortable perhaps, maybe don’t need the income. But complacency by them will detroy the possibility of GP as a career for young uns. Consultants, who largely earn more than GPs, gained public support and got a reasonable pay rise. GPs could do the same. Why would younger doctors want to be GPs if we behave like a spineless bunch of cardies!
JDs have the right idea -ask for 8.7% and don’t take no for an answer. Start low level with minor actions times to coincide with JDs so public realise that we are being reasonable. Stop engaging with medical examiners, switch of GPAD, doing insurance forms, perhaps switch off Patient Access for 24 hrs They will settle JDs -just a question of for what % – why are we the only group that seems happy to lie down and be kicked?

Wendy Harrison 12 March, 2024 9:00 am

Very disappointed with this attitude Copperfield. I expected better. There are many practices, like my own that are actually on the brink of ceasing to exist. Held together by increasing exhausted and dwindling partners taking home less and less renumeration. My business is about to go bust unless we do something dramatic along with alll the accompanying fall out for my staff and patients. Of course I am going to support any action at all that might make a difference no matter how futile it might seem. More understanding reform people observing from the outside without necessarily the same imminent jeopardy would be nice actually !

Rob M 12 March, 2024 11:36 am

Been this steady decline for years and too little too late now. If BMA and GPC had been a proper trade union would never have ended like this – at least not without a fight

C Ovid 12 March, 2024 4:05 pm

I left my partnership in 2015 and have done a range of NHS GP and MOD roles since. All are clinically interesting, challenging and satisfying. We all used to work 0800-midnight every day as partners and all have since moved on. Reassuringly, the old practice is still struggling albeit with a massive APMS uplift. We worked out that we were earning £9.60 per hour. I am not sure what the “benefits of partnership” truly are: we have a strange co-dependency as GP Partners in an abusive realtionship with the NHS. Just walk away and come back on your own terms… oh hang on, it’s already happening. It’s not just NHS Managers and Civil Servants who are baffled by the punishment partners will accept… I am starting to be baffled, too.

Dave Haddock 12 March, 2024 8:24 pm

The answer is of course to “do a dentist”, escape the ghastly NHS, and take back control.
The BMA could revive the “Guernsey Option”, but are ideologically incapable of doing anything actually useful.