After mixed messages in the media, Jaimie Kaffash attempts to clear up the confusion about whether GPs will go on strike or not
Pulse readers may be feeling a little confused today. They will have seen our headline – that the BMA won’t be balloting on industrial action over the imposed contract – and headlines from the rest of the media, including the specialist press, that they will. So let me try and clear up the confusion as best I can.
The BMA GP Committee England (GPCE) convened a special meeting on Thursday to discuss their response to the contract imposition. Following the imposition, acting chair Dr Kieran Sharrock said: ‘General practice can no longer be expected to take whatever is thrown at it, and the Committee’s recent rejection of the contract offer still stands. We will now look to enter serious discussions with our membership and the wider profession on what action we take next.’
That is how we ended up at the special meeting yesterday. And central to that meeting was a motion to discuss whether the BMA should ballot immediately or should use the threat of industrial action as a negotiating tool for the 2024 contract.
A bit more context – this year’s contract is the final year of a five-year deal. There were never supposed to be major changes in the course of the contract, only tinkering. However, the terms of the contract and the annual funding increases were negotiated before Covid and the cost-of-living crisis. (It is, of course, disingenuous of NHS England to cite the five-year agreement as the reason for not uplifting practice funding but not apply the same logic to bringing in new access requirements, but that is a separate issue).
But next year’s contract will be the big one – it could well be a fundamental review of general practice in England, similar to the 2004 contract that removed out-of-hours responsibilities from practices. Getting that contract right is more important than anything.
So the two sides of that motion were clear: ballot the profession on industrial action straight away in response to the imposition; or keep the powder dry for the next contract.
I’m not getting into the rights and wrongs of each approach, and I can see the benefits of both. But these were two separate approaches.
The vote was in favour of not balloting now, and waiting for negotiations for 2024 to start by a margin of 58% to 42%. Basically, GPCE resigned themselves to losing the battle over the 2023/24 contract in the hope of winning the war of 2024 and beyond – as I said, there are decent reasons to take this approach.
This is where Pulse came in. We found this out, and we sent a breaking news email that they had rejected the call for a ballot in response to the imposition. As we understand it, the worries about the impact of Pulse’s story informed debate over the next motion – the one that was released to the press yesterday and created headlines that the BMA may be balloting GPs on industrial action.
The successful motion in full read: ‘This committee calls on the Government to agree a contract with GPC England which recognises and funds the increased workload carried out by general practices, and enables practices to provide safe patient care with freedom and trust.
‘If the Government fails to do this, then this committee will ballot GPs working in England on industrial action.’
Today (Friday 28 April), Dr Sharrock sent a letter to the health secretary. This letter says they will ballot on industrial action in England ‘if the working conditions of GPs are not radically improved’.
But…they have already issued this threat. They issued a list of demands on 22 March that were more concrete than ‘radically improving’ general practice. And none of these have been met by the Government and NHS England. Yesterday’s specially convened meeting was supposed to take this further. For many, that will mean strong timelines, communicated to grassroots members.
Yet they voted against this approach. The motion they agreed upon had almost unanimous support – 98% of committee members voted for it. But this is hardly surprising, as it is reaffirming a threat that had already been made and was supposed to be taken forward yesterday. In other words, yesterday’s meeting lessened the chances of industrial action.
In reality, what the motion passed yesterday means is that the GPC will have this threat in their back pocket while negotiating the major 2024 contract. But it a threat they already had. And had failed to use before.
This might be the best approach in the long run. But GPs in England are stuck with this imposed contract, and they won’t get the chance to take action around it – regardless of the BMA’s spin.