Faith is defined in the English Oxford dictionary as complete trust in someone or something. After the run of disastrous ‘negotiated changes’ to our contracts and pensions, I find it increasingly difficult to trust our negotiators and GPC leaders.
There has been little but bad news for some years, and the gradual reeling in of the 2004 nGMS contract appears nearly complete. ‘No new work without new money’, and the assurance that no government would ever use the impose contract changes, seem almost comical in retrospect. Our negotiators have been marginalized by a Department of Health and Secretary of State apparently intent of dismantling general practice and deprofessionalising GPs.
Our leaders in the GPC and negotiators committee now appear out of touch with the genuine anger and fear amongst the rest of the GP community. Meetings held in camera and regular reassurances that things would have been far worse but for the negotiators’ sterling efforts, do not inspire faith. If we are expected to take a pay cut, work harder and longer, and still smile and say ‘thank you’ do not expect us to be grateful.
Representation at all levels seems to barely reflect the modern workforce. An all-male, all-partner negotiating committee bears little resemblance to a largely feminised, part-time, and sessional workforce. Are you really able to represent our interests when you appear so divorced from the GPs the public meet every day?
There is no doubt that we are dealing with a government that is openly hostile to general practice. They do not value us as providers or commissioners.
We are standing in the eye of the storm as regards out of hours. The rhetoric has been building for some weeks in the media, and we are no doubt to be sacrificed in order to continue the DH agenda.
Another contract imposition with a suitably short ‘consultation’ period, and we shall be back to pre-2004 OOH terms. The one headline clause that swayed so many of us nearly 10 years ago will have gone, and with it the faith and trust in many of us in our negotiators’ abilities to stick up for us and prevent the gutting of our service.
This may well be the tipping point that brings on the retirement bulge that is threatening, whilst simultaneously putting off enough medical students, and encouraging emigration in those who can – those who, with a recruitment crisis already looming, will be hit like a tidal wave. I have little or no faith in our negotiators’ ability to fend off this disaster, or mitigate it any meaningful way that will allow us a living, and be able to look after our patients in any effective way.
The industrial action last year was an unmitigated disaster. We probably chose to try to strike on the wrong issue and the media spun it to the government line with no difficulty. It was mishandled to the point of farce, as grassroots GPs dithered and largely caved in amid lukewarm leadership from the GPC and negotiators. We have killed the golden goose and will have to wait another generation before we can threaten a strike without being laughed out of Whitehall.
We can no longer be wedded to our current ways of working to the exception of all other positions. We don’t just need a plan B – we need a plan C, D, and E with the political will and intent to negotiate a better and fair deal for GPs and our patients. We have been outflanked too many times by the DH and I don’t know if we have any future unless there is a huge change in our professions ability to represent its own interests. We may be hamstrung by our commitment to protect the interests of our patients, but if our model of general practice is made untenable, and one of the many partially privatised, shareholder-owned, and salaried workforce models that appears likely comes to pass, they certainly won’t have any qualms about looking after themselves first, and ‘customers’ second.
We may be dinosaurs, and I strongly suspect that the public is beginning to believe the Government rhetoric to this effect, but we cannot go quietly into the night.
Our negotiators and elected leaders must negotiate like our very lives depend upon the outcome, or they, like us, face extinction.
Dr Richard van Mellaerts is a GP in Kingston in Surrey and a member of Kingston and Richmond LMC
Kingston and Richmond LMC proposed a motion for the LMC conference 2013, that ‘conference believes that GPC and its negotiators have lost the faith of the profession as a result of the outcome of the negotiations over NHS pension scheme changes and the 2013 GP contract imposition.’