Politics is a funny old game. Our leaders seem increasingly impotent in the face of events, despite all the trappings of a modern democracy.
And this is reflected in medical politics. My overwhelming impression of this week’s statement from the GPC was that it sounded like a retreat.
Sure, I get that mass resignation was always going to be difficult (if not impossible). It was an imperfect solution foisted on the GPC at the end of a ‘special’ LMCs conference in January that was keen to be seen to ‘do something’.
Where is the new hope for a demoralised profession?
LMC representatives went home satisfied. Not many took pause to think about whether resigning was a workable solution or not. Mass resignation meant something in the 1960s when most GPs were partners and the NHS was very young. Now the risk is that Jeremy Hunt would simply say: ‘Go on then.’
But I worry that, rather than heed the will of grassroots GPs, the profession’s leaders have chosen to listen to the very ‘platitudes’ from NHS England that GPC chair Dr Chaand Nagpaul railed against in his speech in January.
May’s LMCs Conference was very clear that unless NHS bosses ‘accepted’ the GPC’s Urgent Prescription for General Practice, support would have to be canvassed for mass resignation and/or industrial action. NHS England mirrored this wording in its letter to the GPC, saying that it ‘accepts the BMA’s Urgent Prescription as a good basis for further discussion’ – but that has a very different meaning.
Dr Nagpaul tells Pulse that legal advice and feedback from GPs contributed to the decision to drop plans to ballot the profession on industrial action, but the fight for the future of general practice seems to have boiled down to a few vague statements, such as ‘ensuring that GPs work within safe limits’, ‘enabling GPs to have longer appointments’ and ‘empowering patients to better manage their own health’.
Where is the radical change that will dissuade hard-pressed GP partners from retiring or locuming? What happened to all the ‘if not now, when’ fighting talk from the LMCs Conference? Where is the new hope so badly needed by a demoralised profession?
The BMA will carry out yet another survey of GPs next month ‘to ensure that the profession’s priorities and views are properly taken on board when we continue our negotiations in the future’. But cold, hard cash is what will make a difference to practices in dire straits right now. Cold, hard commitments to relieve workload.
The GPC should be demanding the promised £2.4bn from the GP Forward View now, not accepting £30m to reimburse rises in indemnity fees next April. It should be demanding compensation for the failure of support services and refusing point-blank to accept any more patients until the QOF is suspended, CQC inspections are binned and the funding for the unplanned admissions DES is paid in full to practices whether they have done the work or not.
I despair, I really do. OK, I urged the GPC to not jump the derny last week on this issue, but chucking the bike away at the starting line is a bit much. Yes, I am a mere journalist shouting from the sidelines – I would make a terrible politician – and there has been ’considerable dialogue’ behind the scenes, but there are other options the GPC could take to protest (check here for a list).
The thing needed right now is brave leadership, but all I can see is the GPC eagerly opening a giant box of Daz to make its white flag look even whiter.
Nigel Praities is editor of Pulse