That is the question on GPs’ lips after NHS England’s contract imposition, says Dr David Turner
Following NHS England’s contract imposition, which focuses on improving access at a time of increasing patient demand and ever decreasing GP numbers, many in the profession are questioning the motives behind this move.
As a result, GP leaders have started to have conversations about whether we want to take industrial action – and if so, what form it should take. But what do we actually want?
Most striking workers in recent months have had a very clear demand.
‘What do we want?’
‘X per cent increase now.’
I’m not sure what the equivalent chant would be for GPs.
‘What do we want?’
‘A recognition and financial recompense for the systemic underinvestment in primary care over the decades, freedom from a tick-box culture and release from the endless hoop jumping for crumbs of income’ does lack something of a ring to it.
Our LMC has had discussions about what form any industrial action could take if the profession were to vote for it. As independent contractors, we would be in breach of contract if we withdrew our labour. Although what anyone could do about it if we all came together, I’m not quite sure.
One suggestion has been to close our surgeries for a couple of days and stop working like junior doctors. The problem I see with that is, our work does not just go away. The patients will all pile in the day we reopen, making our lives worse than a day in hell. Not to mention the vitriolic columns that this would spawn about ‘greedy, lazy GPs’ in certain sections of the media.
Another idea would be to refuse to engage with CQC inspections, appraisal or revalidation. None of these activities would affect patient care in any way. In fact, I would wager the average patient is oblivious to the fact that we have to undergo these mostly pointless rituals.
I personally would favour the latter approach. The Government may not care very much about whether we let an inspector in to check behind our bins for maggots or not, but if we acted together, it would show unity and strength, and I suspect that would get a few sphincters twitching in Whitehall.
Let’s be clear, the Government neither respect nor fear GPs. But if we could come together as a profession and refuse to engage in activities that have no impact on patients, we could show them we are powerful.
I would prefer if the Government respected us, but fearing us is a good second best.
Dr David Turner is a GP in Hertfordshire. Read more of his blogs here
I think it is actually important that Practices stay Open : but fail to comply with some regulation that brings down the heavy hand of some NHS body : the subsequent imposed closure by DoH because GPs ‘were too busy seeing sick people’ to tick the ‘absence of maggots behind the fridge’ box, would gain additional support from our patients, which we would need for success.
We would have to be careful to ensure that it is a ‘theoretically but not actually’ dangerous failure, contrary to DOH demands, rather than something they could just fine us for, though.
Something like persistent illegal use of NHS logos on the face of the building; or refusal to let in the CQC, or prescribing the more expensive brands, or some ‘serious’ IT malpractice?
They were unite prepared to let people die at home waiting for an ambulance. Do you think that they would give a hoot if GPs stopped signing sick notes or whatever.
It requires unity.
I recall that the last ballot GPs chickened out and voted no. At that time only the smaller practices were being pushed out of business so the majority left them to it.