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A historic vote, now over to you GPC

Emboldened by the juniors, the LMCs Conference has mandated the GPC to ballot the profession on its willingness to take industrial action within three months. If nothing changes by July, then GPs could be asked if they want to put their name to undated resignations.

If NHS England accedes to demands in the GPC’s prescription for general practice by the end of the summer, this could blow over.  

The feeling that ‘something must be done’ was intoxicating 

But the message is clear from LMCs. The promises of £2.4bn of ’jam tomorrow’ contained in the GP Forward View are not enough. It has been judged wanting.

Dire warnings of multiple GP practices going to the wall are being realised. We are hearing that NHS Pensions is struggling to keep up with requests to retire. Recruitment problems are worsening. 

I sat in the hall listening to speaker after speaker detail sad stories about GPs struggling to cope.

Dr Shaba Nabi’s speech was the most impassioned. Near to tears, she described how she has resigned from her partnership and has gone salaried. Her grief about the loss of the career she has taken years to build was palpable.

Her Pulse blog – published today – on the same issue is very hard to read, but I urge you to.

Because it could be seen as the perfect foil to all the sunny promises contained in the GP Forward View. All the talk of ‘transformation’ and ‘resilience’ sounds very hollow when compared with her story and she is not alone.

These mini tragedies have all added up to a real impetus within general practice for change. The feeling that ‘something must be done’ was intoxicating in the hall today. 

I got the sense that many representatives knew if they came home from the LMCs Conference empty-handed, their members would start to question their usefulness. I lost count of the number of speakers who said: ‘If not now, then when?’

In the end, mass undated resignation was the only option spelled out on the voting paper, but you will notice that there is wiggle-room for a ballot on other modes of action. It will be interesting to see what direction the GPC will take, and how ministers will respond.

Over the next three months, GPC chair Dr Chaand Nagpaul and his team will have to figure out how they would implement this new policy. Industrial action against, even the most benign of governments, is dangerous and requires unity.

The GPC is riven on this issue (some observed the vote with barely disguised horror). Some I spoke to today questioned whether mass resignation would be the right option. They muttered darkly that GP partners, when it came to the crunch, would not necessarily be willing to risk their livelihoods. Others were concerned about the impact of the uncertainty on patients and practices; the lack of public sympathy for the profession is a concern.

There is a massive unanswered question over how this all applies to sessional GPs and those in the devolved nations, where relations are less strained. 

Also, as we enter the soporific summer months, all the passion displayed at the LMCs Conference may wane. The temptation to triangulate will become more powerful. National attention will shift to the crisis in acute trust finances. GPs will be distracted by their own problems.

But the GPC has to work hard and fast to develop a clear public narrative about the action they propose and why it may be needed. The ground work must be put in to ensure the profession is united with common cause if the time comes – and does not look like it is crying ‘wolf’ (remember the pensions ’day of action’?).

The grassroots have spoken – now some strong leadership is required.

Nigel Praities is editor of Pulse