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In January 2016, at a special LMC conference delegates voted overwhelmingly to carry a motion proposing that the GPC should canvass GP’s on their willingness to submit undated letters of resignation. At that time www.dealdirectlocums.com reported on the likelihood of a mass resignation from GPs across England. The only caveat to avoid such action was for successful negotiations with Government to take place. GPs have been demanding an equitable and sustainable rescue package for General Practice for years. A deadline of six months was issued before industrial action would be considered.

Six months have now elapsed and during this week the GPC will be informing LMCs on their decision about whether or not the profession will be balloted in relation to mass resignation. It seems likely that a ballot is imminent despite lots of engagement with NHS England, as not all of the demands of the GPC which are outlined in the ‘Urgent Prescription for General Practice’ have been met. ‘General Practice Forward View’ has generated mixed opinions across the profession, and despite some seeing the reforms as a step in the right direction; the changes they are set to bring about may not be radical enough to prevent the ballot from going ahead.
The measures that GP’s are insisting must be enforced include:

– The introduction of 15 minute consultations.
– A maximum limit on the numbers of patients that a GP can see in a day.
– A detailed list of services, not currently covered in core GMS, which are optional for Practices and are subject to national benchmarks in relation to pricing.
– Cessation of duplication concerning CQC and NHS performer list registrations.
– Agreement of nationally defined contract for GPs employed by other providers.
– The creation of a new care home DES.

Compounding these issues are increasing demand, low recruitment and retention rates, professional isolation, increasing rates of stress and mental health amongst the profession, and creeping indemnity fees. These issues are making General Practice an unattractive place to practice medicine. The solution for many within the profession is simple; the Government need to provide better contracts and working conditions for their workforce. With a more motivated and engaged workforce comes better patient satisfaction and outcomes. One therefore has to ask, why is the Government not doing everything within their power to stop this from becoming a reality? This isn’t just about pay, as reports from across the media suggest, but instead it is about time and investment, and the inevitability of real system change that can result if both are made available.

With most Practices being private businesses, the issues within General Practice are financially, morally, politically and ethically a minefield to traverse. GP’s want the best for their patients, but the ballot is a long time coming for many, and the Government doesn’t appear to be taking the necessary steps to avoid industrial action. There is widespread opinion from many within the ranks of the LMCs that the ballot is being welcomed by Government, who would be happy to lose the independent provider status of GPs, especially as the media once again aggravates stories of privatization of the NHS. Half-hearted attempts to ease lay members of the public don’t cut to the heart of the problems in General Practice and that is why the GPC may call to arms. Only real reform and a real commitment from the Government will prevent GPC members from voting with their feet.

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