Who were the 0.8% who voted ‘yes’?

Editor Jaimie Kaffash ponders the identities of the culprits who voted to accept the Government’s 2024/25 general practice contract changes in the BMA referendum

The results from the BMA’s ballot on the GP contract were shocking. Why did 0.8% of the GP population vote in favour of the contract?! Who exactly were these 155 GPs who voted ‘yes’ to the question ‘Do you accept the 2024/25 GMS contract for general practice from Government and NHS England?’ Who thought that a 2.8% funding uplift in a cost-of-living crisis was something that GPs should accept without complaint? I’ve tried to break down who these GPs could be.

42 ICB clinical advisers: To be fair to ICBs, they’ve been given a bit of a shitty deal from Government with all the responsibility to improve general practice with no funding. But they are taking on that role with gusto, trying to change the whole concept of general practice with the hope that no one notices. Having a dreadful GMS contract will make people less bothered when they try and remove same-day care from GPs, or triage everyone through NHS 111, or replace all GPs with homeopaths or whatever.

50 ‘medical general practitioners’: ‘Physician associates’ is becoming a loaded term, and it’s right that we are looking at new ways of explaining them. Just because their education and training is half the length of a GP, it doesn’t make them any less able to see undifferentiated patients. So ‘medical general practitioners’ makes sense – they work in medicine, that deal in general health, and they practise. Some of these will have been sent ballot papers by some tired BMA admin staff. For these MGPs, NHS England’s direction of travel is spot on – put all the money in the ARRS. A yes vote makes sense.

10 fictional doctors: The likes of Doc Martin, Dr Legge and Dr Finlay are having a lovely time of things, providing loads of home visits every day, being pillars of their communities and facing no burnout. They are all happy with the contract as it stands. (Admittedly, Dr Finlay wouldn’t receive ballot papers on account of being Scottish, but if you felt the need to point this out, I would counter that being fictional is a bigger barrier to him voting.)

22 NHS England GPs: There are a lot of GPs working within NHS England  – after all, those thought leadership frameworks don’t vertically integrate themselves. These GPs would have voted yes. But primary care medical director and NHS England lead negotiator Dr Amanda Doyle wouldn’t have been among them – she’s made very thinly veiled comments admitting how poor the contract is.

1 Dr Martin Scurr: The Daily Mail’s go-to self-hating GP was wavering on whether to vote ‘no’, because the offer was too generous. But he decided that reducing funding would lead to even more GPs leaving the NHS and going private, thereby providing his private practice with unwanted competition.

30 GPs who didn’t read the question properly: I was going to include more fictional doctors, but the closure of BBC’s Doctors surgery – presumably in a bid to mirror real life – has left me short of the magic 155 number, so I can only presume that dozens of GPs misread the question. Because surely there aren’t 155 GPs who genuinely voted in favour of the offer in good confidence?

Jaimie Kaffash is editor of Pulse. Follow him on X (formerly Twitter) @jkaffash or email him at editor@pulsetoday.co.uk