The question on everyone’s lips is, ‘If not now, when?’ And the answer’s much the same, whether it’s a patient asking about the next available appointment, or the LMCs Conference testing our willingness to take industrial action. That answer, of course, is ‘never’. Which is tough on a patient with chest pain. But from the LMCs’ perspective? It’s either an admission that we’re perpetually unable to get our militant act together or, as I’d prefer, a genuine call to arms, because Now Is The Time.
We’re resigned to resigning
And it really is. After all, what have we got to lose? Everyone has resigned, is resigning or is on the brink of resignation. We’re resigned to resigning. Handing in signed, undated resignations just gives us the opportunity to co-ordinate this process. In doing so, we create a political lever potentially powerful enough to haul us back from the brink.
The climate’s right, after all, given the junior doctors’ recent battle with the Government. If anything, our case is stronger and clearer, because the juniors’ argument sat slightly uncomfortably somewhere between pay and safety. No such fudge with us GPs. Sorry to reprise previous blogs, but our issue is about wanting less work, not more pay. And we want less work because we’re currently too busy to be safe – a message that will play well with the public and also happens to be 100% true.
The problem is, threatening action because the Government’s Forward View is inadequate, and demanding acceptance of the BMA’s ‘Urgent Prescription for General Practice’ in its entirety, risks the politicians just negotiating some God-awful mash-up of the two: another lamebrained, strings-attached IOU cooked up in the hope that we’ll all crawl back to our primary care sweatshops. Instead, the ultimatum should be focused, realistic and non-negotiable. We’ve managed it before, after all: losing responsibility for out-of-hours care transformed our lives for the better overnight. Over one well-rested night, to be specific. Yes, we had to pay for the privilege and we shouldn’t have to this time, because God knows the Government owes us. But it shows it can be done.
And the specific, game-changing idea is right there in the BMA’s Urgent Prescription: cap our daytime work. Set a limit on the number of appointments we can safely provide. Difficult, but not impossible. Costly, but affordable – particularly given the pots of money conjured up for the Forward View. Sure, pursue other areas in due course. But do this one thing. Right now. Or else.
Imagine it. Coming to work on a Monday knowing that there’s a lid on the week’s workload. I might not be singing my way to work, but I wouldn’t be weeping, either, and that would be a good start.
If not now, when? Surely, not when, now?
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield