Dr Copperfield on why over half of England’s GP practices have not started taking collective action
I found myself getting nostalgic watching the Paris Olympics, and not just for my days as a professional break-dancer. It reminded me of London 2012 and going misty-eyed at the children bouncing on NHS beds in Danny Boyle’s opening ceremony.
Now, just hold that image, would you, as I take a swerve onto Pulse’s recent survey. It revealed that nearly half of England’s GP practices have started taking collective action. Which also means that half of England’s GP practices have not started taking collective action.
If I were health secretary, I’d be incontinent with joy: even when supposedly galvanised, GPs can’t summon the will to simply work to contract, let alone strike! And the excuses are so lily-livered: they’re waiting for the BMA to tell them what to do, or for the big boys and girls of the practice to return from hols, or for mummy to tell them it’ll all be OK, or whatever!! Pass the pads!!!
In fact, those limp rationalisations hide a much more profound truth, which we GPs are probably too embarrassed to admit. And it’s this: GPs continue to feel some strange but irresistible moral duty to prop up the NHS.
Stop sniggering at the back. I know this flies in the face of the tough-talking rhetoric from our leaders. But hear me out. When I was a houseman, I finished my first half day at 11pm. And I turned up on a bank holiday simply because it hadn’t occurred to me that I wouldn’t be expected at work. Youthful naivety, perhaps, but this work ethic and sense of duty was endemic. It soon became apparent to me that the NHS ran, to a large extent, on the goodwill of its workforce.
This attitude may have been diluted but it isn’t lost, certainly not in general practice. Even now, 40 years later, every GP I know logs onto the practice system well outside of contracted hours to prepare for the next day or mop up the previous one.
I’m not saying this is right or wrong. I’m just saying it’s a fact. And ‘working our contract’ would in fact mean ‘working a contraction’ in terms of what we actually do and how we see ourselves. It would require a massive attitudinal U-turn for many of us – which is, I suspect, the actual reason why the response to collective action has, literally, been half-hearted.
Maybe we’ll take a lead from the junior docs and decide we’ve been benignly insane to subsidise the NHS all these years. Besides, what do we want for this Olympian feat, a medal?
The sad and inevitable fact is that working to contract is a withdrawal of that goodwill. This in turn means the NHS could not possibly exist in its current form, and no amount of funding will replace what’s been lost. That might still be a price worth paying. But it does mean that in future opening ceremonies, there will be no children bouncing on beds. Because there will be no beds, and there will be no pride.
Dr Tony Copperfield is a GP in Essex. Read more of his blogs here
Hey Tony, with the greatest of respect you’re wrong. We are not taking action. The proposed “actions” are so trivial, so deeply ineffectual it’s not worth the bother. And with the NHS as it is, when shit happens WE will now be blamed for it whether we are responsible or not.
Well said Tony. Doctors working in the NHS particularly GPs continue to show a naivety not present in other professions or workplaces. It’s like we have not grown up and the NHS takes advantage of this. In fact, in the late 80s during medical school, this ethos of the NHS being something greater was the subliminal mantra drilled into us and probably still is. Truth is we are stupid. Doing what you are paid for only or as you are contracted should be the norm and service failure is the only thing that may incentive any additional required funding. We will get blamed but who cares! GP have in my 30 years in the NHS been responsible for all the ills of the world so no change there….and if there is no funding, we should be prepared cut services to only a safe contractual level (including dumping the absurd 10 minute appointment we seem so resistant to change to facilitate bums on seats at the expense of real quality care aiming for max 20 patients per day) or be prepared to walk out of the NHS. The burden of service delivery is not ours to carry and we should stop being martyrs heading to an early death.
Agree Tony but you forgot to mention natural selection. We have an odd bunch left working as partners. Most folk with self respect left already. A significant proportion of the ones who remain (may I hazard around 50%) don’t have any.
Sorry Coppers, I’m afraid you are wrong on this one.
The inaction more likely relates to:
1. 1st August being the start of consecutive summer holidays for partners and LMC officers
2. Individual practices awaiting consensus facilitated by LMCs
3. LMC members events being delayed to September due to (1)
I have just returned from leave and my area is likely to go live next month to allow maximum engagement so we can move forward with a consensus.
DOI: LMC Chair
Told you all
‘If I were health secretary, I’d be incontinent with joy’ – you don’t mean pissing yourself????
‘Sorry Coppers, I’m afraid you are wrong on this one.
The inaction more likely relates to:
1. 1st August being the start of consecutive summer holidays for partners and LMC officers
2. Individual practices awaiting consensus facilitated by LMCs
3. LMC members events being delayed to September due to (1)
I have just returned from leave and my area is likely to go live next month to allow maximum engagement so we can move forward with a consensus
DOI: LMC Chair’
Have no idea or concern with what you are talking about Shaba. Just pay people for their professional input?
PCN CD ‘Pied Pipers’ are leading the entire profession of Primary Care , GPs, ARRs and particularly newly qualified GPs to the cliff edge and all continue to blindly follow these egotistical (not all) GP PCN CDs.
This is evidenced by increasing fragmentation of core General Practices, the creation of highly lucrative and profitable PCN groups for the few and their associated limited companies.
For these GP PCN CDs (paid handsomely by their masters NHS England) and their business partners, they and NHSE have now gained large GP Groups ripe for privatisation or other suitable PCN/NHSE contractual agreements and this happening before our very eyes comparable to an uncontrollable proliferation of genital warts.
Hard to imagine a profession with a more ludicrous plan where unfortunately the most influential leaders (in many case in post by default) are pivotal in the destruction of their colleagues’ careers and are actively facilitating this destruction of Primary care in return for and incentivised by bags of Gold in respect of GP PCN CD payments.
No action will be effective until the insatiable greed of PCN CDs(not all) and their motivation for money, status, control over the careers of others is challenged and any influence they have within the BMA, LMCs , ICBs and any negotiating committees is curbed as their motivation in my view is not the future of General Practice but simply personal gain.