GPCE chair Dr Katie Bramall: ‘I am not in Wes’s pocket’

In an exclusive op-ed for Pulse, BMA GP Committee chair Dr Katie Bramall comes out in denial of accusations that she and her executive team agreed 1 October contract changes and have misled the profession.

It’s unusual for the GPCE chair to write in Pulse, but the Government has chosen to confront the profession and I wanted to reach out as widely as possible to GPs to set the record straight, rather than be dragged into manufactured political dramas, deliberately timed to cause maximum distraction given both England’s Conference of LMCs in Manchester, and the resident strike action.

We wrote to the Government on 4 November. Their response was to release selective correspondence less than 48 hours later – we had clearly struck a nerve. Following my conference speech, a shutdown of engagement with GPC England was instructed. This was not the act of a government confident in the strength of its position, but of one that felt exposed – we were not arguing about money – this is about patient safety and keeping your word. GPC England’s letters are available on the BMA website for GPs to make up their own minds – we have nothing to hide.

Most of the profession is strongly opposed to the current positioning of the Government. In Manchester, we saw hundreds of LMC representative GPs upstanding for us in a clear demonstration of professional unity.

There have been suggestions that I am ‘in Wes’s pocket’. Wrong – I seek reasonable dialogue to serve the needs of GPs. Dialogue is not agreement. General practice runs through me and my officers like a stick of Blackpool Rock. If general practice is threatened, we will fight. I have worked a total of 14 years as both a GP partner and an LMC secretary; collectively our officer team has over 100 years’ experience in representing, supporting and advising practices across the country. To suggest that only current partners can do our role stems from an unhelpful mix of sexism and nostalgia for a power structure that no longer reflects the modern GP workforce.

The problems we face are caused by the Government shifting its position and breaking its word. When the contract was locked down in NHSE’s letter to the profession on 18 February it was on the condition we would work together to apply proper safeguards to online consultation tools and GP Connect. They have chosen to release non-committal discursive emails to disguise their change in stance.

It is obvious to anyone who works in general practice, that of course no single online consultation software solution could ever be mandated. We work in a complex healthcare environment made up of different online providers, with different systems. We all needed to work together to make Wes Streeting’s contractual ‘red line’ a safe reality. The paper trail throughout 2025 shows that against all advice from GPC England and JGPITC the Government/NHSE/DHSC consistently failed to address all the problems that have come to pass, until finally dispute became inevitable.

In 2024 we determined to negotiate tricky waters with the new Government in good faith. We sympathised with their difficult position and proposed ways forward that would work for both them and our profession. Now, they are lashing out defensively. They know they have let us down, most importantly over Wes Streeting’s written promise regarding a new contract, only to publish a 10-year health plan which completely omits GMS but promises single and multi-neighbourhood model contracts. That is the truth they are trying to bury under noise, spin, and strategic outrage.

What comes next?

Over 1,000 (more than 1 in 5) practices completed our GPC England online consultation tools survey. We release the findings tomorrow, and will be writing to the Government to ask for a meeting to discuss the patient safety concerns. We will also be holding a series of national webinars to give every GP practice clarity on the political landscape, what lies around the corner, and how they need to take informed decisions very soon to protect their businesses and their staff. We fear things will get worse before they get better, so as a profession, we require courage and most importantly, unity. 

With a planned uplift for practices next year of 2.5% – against CPI at 3.6% – the Government is openly signalling its priorities.  It wants ‘access’ headlines while continuity collapses, GPs remain under-employed, and we witness patient safety being compromised. Resolutions determined by our national LMC Conference earlier this month will now provide vital levers.

The Government is right that general practice is the front door to the NHS, but it is wrong in continually refusing to understand how it works. If ministers collaborate with us (rather than brief against us) there is still ample opportunity for Wes Streeting to rebuild general practice, which will transform the NHS experience for the 1.5 million patients who use it every day.

Remember – a fractured profession benefits the Government.

Now is the time to stand together, and take whatever steps are required to protect general practice for the next generation; the stakes are nothing less than the future of our profession, so let’s not indulge those who would rather us be a profession of protest.

Instead, let’s fight for our practices, their staff, and our patients.

Dr Katie Bramall is chair of the BMA’s GP committee in England