This is the first year since being on the executive committee of a LMC that I have not attended the Annual Conference of LMCs.
A mere seven years ago I attended my first Conference. Back then, I felt proud to represent my area and was eager to submit pages and pages of motions in the hope of a chance to debate all of the issues that ailed general practice and to succeed in setting the national agenda for change.
I used to canvas local GPs for their thoughts and ideas of what they wanted the NHS to look like and as their representative I’d take these fledgling ideas and spend weeks contorting them into prize winning motions. To me, these words were my chance to make general practice better.
Shortly after submitting my work, I’d sit like a child waiting for Christmas eagerly awaiting the delivery of the Conference agenda keen to see which challenges we would tackle and solve this year.
Conference often seems ineffectual and unwilling to make bold statements that would revolutionise the system
It took me a while to realise that the agenda was not really a collection of ground breaking ideas but in my opinion had been carefully crafted to reflect a mixture of achievable goals with a sprinkle of attention grabbing soundbites. I’m pretty sure I felt a part of my soul die on the day that I learned this.
Nonetheless, I used to feel excitement for the big day of Conference. I would spend weeks writing a number of persuasive arguments. I’d practice my timing and gesticulate in front of the mirror. In my mind I wasn’t just debating, I was influencing a nation of GPs on how we could shape the future of the NHS. I knew that the outcome of these debates set the mandate for our national negotiators to deliver us success and that it was our duty to describe that to them.
Fast forward some years and I’m now a member of the GP Committee of the BMA. I feel secure in the knowledge that the Conference agenda does set a mandate for our executive team and that we are often reminded of Conference motions when as a committee we discuss national issues.
I’m also aware however, that it’s not LMCs or the BMA who are in control of the NHS. The NHS is a top-down organisation that dances to the tune of the Secretary of State for Health, his or her advisors and the Treasury. The rest of the plan from there down to grass roots seems to be an amalgamation of aspiration, compromise and damage limitation from numerous vested interest organisations, of which the BMA and LMCs are but a few. Conference may generate wishes, but without the ear and will of Government, wishes are likely to remain just that.
Like you, I’m disappointed in the Conference of LMCs. I’m disappointed that it often seems ineffectual and unwilling at times to make bold statements that would revolutionise the systems in which we work. However, it’s important to recognise that whilst Conference may fail to deliver on our contractual desires, for some it does deliver a feeling of strength, solidarity and voice.
I might not need Conference in its current form, but many still do.
Dr Dean Eggitt is a GP partner in Doncaster, chief executive of Doncaster LMC and regional GPC representative
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