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A timely opportunity for LMCs to make GPs’ anger heard

The first time I ever attended the LMCs conference, I met a journalist who had covered it for seven years running. 

To a young reporter brand new to the world of general practice, it was a somewhat bewildering experience. Hundreds of GPs from all over the country, earnestly debating the minutiae of practice finance. A hefty booklet of motions, parts of motions and ‘agenda committee’ motions. The constant reference to ‘conference’ as if she was a person; the impenetrable in-jokes between long-standing delegates; the baffling cries of ‘next business’. 

Stick with it, the journalist told me, and it’ll make sense. 

Tomorrow the 2013 LMCs conference gets underway, back in the familiar subterranean hall at the Institute of Education in central London after two years on the road. It will, unbelievably, be my seventh LMCs conference - and it’s starting to make sense. 

There’s a familiar rhythm to the conference, which always takes place on a Thursday and a Friday in early summer.

It invariably begins with a bang; a tub-thumping address from the current GPC chair, summarising the past year and looking ahead to the next. (This year’s speech – Dr Laurence Buckman’s last after six years in the hot seat – may be more tub-thumping than most).

A couple of motherhood and apple pie motions follow to get the delegates warmed up, and then we’re into the tricky stuff – a series of heated debates on the most pressing issues facing general practice (111, revalidation and the GP contract imposition all feature on the agenda this year).

After lunch the pace changes somewhat, with more debates and updates from devolved nations in the afternoon of day one. Day two always starts in somewhat subdued fashion, with speakers making knowing references to the night before, but by the time delegates get the opportunity to quiz GPC negotiators, conference is in full swing again.

There’s a comforting routine – applause for first-time speakers, excited hush when motions go to an electronic vote, the odd comedy motion with speakers in fancy dress – and always a surprise or two as well. The atmosphere is unique - somewhere between that of a militant trade union debate and a collegiate professorial conference.

To what end? Well, in theory LMC delegates set GPC policy for the coming year.

In practice, that doesn’t always happen. Last year’s conference saw LMCs demand that ‘disengagement of GPs from clinical commissioning be included in any industrial action’, which didn’t happen. An unexpected vote instructing the GPC to negotiate a change in the GMS contract that would allow patients to receive treatment not funded by the NHS from their own GP on a private basis perhaps understandably didn’t go anywhere either.

But perhaps more important than its policy-setting role is the opportunity the LMCs conference gives for grassroots GPs to make their hopes, fears and ocassionally anger heard. The first morning of the conference is always attended in force by the national media, and there’s an element of theatre about proceedings. Both speakers on stage and delegates in the audience talk to a much wider audience – giving, as LMCs conference chair Dr Mike Ingram puts it, voice to the ‘hacked-off GP’.

In 2007 it was a pay freeze delegates were up in arms about, then extended hours and the NHS reforms. This year the focus was expected to be the aftermath of the GP contract imposition; instead, incredibly, it now seems like the prospect of further dramatic contract changes – and the spectre of out-of-hours responsibility – will take centre stage instead.

With perfect timing, Jeremy Hunt will deliver his much-trailed speech touting a return to the ‘family doctor’ tomorrow afternoonat the King’s Fund, just a mile as the crow flies from where hundreds of those family doctors will debate the increasingly uncertain future of their profession.

Expect fireworks. Expect grandstanding. Expect a lot of heartfelt GP anger. The LMCs conference has always been the perfect outlet for ordinary GPs to make their voice heard. At the moment they have quite a lot to shout about.

Steve Nowottny is the editor of Pulse. You can follow him on Twitter @stevenowottny and see all Pulse’s coverage of the LMCs conference on our dedicated page

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