ANGRY GPs on Saturday voted for action over underfunding and a workload that threatens patient safety and their own health.
But at the start of a special conference over 350 delegates in London, called by the British Medical Association (BMA) GPs Committee (GPC), conference chair Guy Watkins warned: ‘GPs can’t break the law.
‘There can be no call for industrial action that is not legal. It’s my job to stop you breaking the law.’
In a challenge to the agenda committee Jim Kelly, Kent local medical committee (LMC), said: ‘One of the few motions that provided a solution, our motion was ruled out because of clause (iii) for industrial action.’
Watkins responded: ‘I’ve had advice from the BMA legal department and industrial action would be unlawful.’
Joe Reison, Tyneside LMC, contested this, saying: ‘The idea that we cannot have industrial action because we are self-employed is wrong, some of us are employed.’
Watkins ruled: ‘Industrial action being illegal has nothing to do with being employed or self-employed.’
Delegates went on to vote with just one against for amended motion 20 from Buckinghamshire LMC.
This states: ‘That conference instructs GPC that should negotiations with government for a rescue passage for general practice not be concluded successfully within 6 months at the end of this conference.
‘(i) actions that GPs can undertake without breaking their contracts be identified to the profession
‘(ii) a ballot of GPs should be considered regarding what work/services must cease to reduce the workload to ensure safe and sustainable care for patients
‘(iii) the GPC should canvass GPs on their willingness to submit undated resignations.
Mover James Murphy, Buckinghamshire LMC, said: ‘Hope is fading fast. It seems we are stuck on a warlike footing. I’m worried about my patients.They are left short-changed. Enough is enough. I feel we are fighting for survival. We must stop the government from using our heartfelt care for patients to be exploited as a weakness. Pass this motion and we will be saying loud and clear to Mr Cameron, Mr Hunt and the press we can’t go on like this.’
In a reference to opening remarks of conference chairman Guy Watkins at the start of the day, that GPs could only take lawful industrial action, seconder, Stephen Strange, LMC, said: ‘General practice in Birmingham is in crisis. I want to know what we can do about it. What things are legal and not legal. To protect general practice, support all of the motion.’
Anthony O’Brien, Devon LMC, opposed canvassing for mass resignations. He said: ‘That’s not possible without a massive public relations campaign. We need solutions. Mass resignations is not one, proper investment would be one.’
Naomi Beer, City and East London LMC, urged: ‘Vote unanimously for all parts to send this government a message that GPs will not be a party to this destruction anymore. How much longer can Jeremy Hunt expect us to dance to his tune? We have to get the message across that we are not prepared to work in an unsafe system and take the blame.’
Katy Brammall-Stainer, Hertfordshire LMC, condemned ‘problems caused by immoral politicians’. She said: ‘It’s not just about patients, it’s about our physical health. This is about losing our homes, it’s about our lives. This is the headline to launch our campaign.’
Paul Scott, North Staffordshire LMC, said: ‘Nineteen out of 93 practices in my area are right on the edge of closure. If this motion is not passed many will vote with their feet. GPC show some backbone, take off your cardigans and take the government on.’
Clare Bannon, Barnsley LMC, declared: ‘There are no solutions at this conference.
‘It’s restricted our ability to say what we really feel and what we really need with watered down motions. We don’t want to consult on a ballot, we want to force them to do it. Motion 20 is nonsense, it does not give the GPC power to effect change.’
Peter Geldhill, Bedfordshire LMC, said: ‘Mass resignations was effective action by GPs in the past. Give the GPC the power they need by voting for paragraph three.’
Gaurav Gupta, Kent LMC, said: ‘The contract is exploitative and underfunded. We need better. It’s time for action, not procrastination.’
Alex Freeman, Hampshire and Isle of Wight LMC, said: ‘I want to know what every single GP in this room and outside is prepared to do to save general practice. If you call on GPC to call action you must take it. Look at the junior doctors dispute. If you care about your profession do something about it.’
Martin McCloskey, Northern Ireland Western LMC, said: ‘Sadly we are faced with a government that won’t listen. We need to give the GPC the clout they need. We need to consider industrial action. We have to make it clear that if there is not action to maintain general practice there will be consequences.’
Zoe Norris, Hull and East Yorkshire LMC, said: ‘I didn’t sign up to be a saint. I didn’t sign up to lose my health. The junior doctors were successful to threaten and do the unthinkable. The government now know they mean business. This motion is a challenge. The GPC can tell the government give us resources we need or we will ballot, we will do something about it.’
Recommending support for the motion, GPC chair Chaand Nagpaul said: ‘One thing we can learn from our junior colleagues is to recognise who the enemy is. The second is unity, junior doctors voted 98% for action. GPs let’s be together for the challenge. Let’s do everything we can to safeguard our profession.’
Earlier GPs voted for measures to increase time spent with patients, against stopping GP responsibility for home visits, to defend the independent contractor model, to call on government to reduce student loans, against a commission to look at a future form, function and funding of the NHS.
There was an angry condemnation of Care Quality Commission inspections in a motion also opposing any increase and demanding a reimbursement of inspection fees. GPs also voted for ways to increase funding for premises, increased pay and to look for ways to reduce exorbitant medical indemnity insurance premiums.
In his opening speech GPC chair Dr Nagpaul had warned that progressive resource starvation and thoughtless workforce planning has resulted in the proportion of NHS doctors who are GPs reducing from 36% to 25% in two decades and with fewer GPs per head today than 2010.
‘Yet we’re now seeing a record 370 million patients annually in general practice – that’s 150,000 more patients daily compared to 7 years ago. This gross mismatch between demand and capacity is untenable.’
He added: ‘So, Conference, today marks the great fightback of UK general practice. I urge government to do the right thing for patients and equally the right thing for a GP workforce whose goodwill continues to be shamefully exploited.
‘And to protect and nurture a discipline that’s not just the jewel in the NHS’s crown but a beacon of personalised continuity of care internationally. And to make 2016 the year in which we begin the revival of UK general practice so that we have a future generation of GPs to look after a future generation of patients.’
At the end of conference there was a demonstration outside of about twenty people organised by Doctors in Unite. They welcomed GPs leaving. Ron Singer chair of Doctors in Unite said: ‘We’re here to support GPs because we recognise how important they are in the defence of the NHS. We understand you had a good conference, and you are going to take the fight to the government.’
Junior doctor Tim Yates said: ‘Junior doctors support GPs. You’ve been on our picket lines.’ Consultant psychiatrist Matteo Pizzo said: ‘Ten-minute consultations are not enough. Patients and you GPs need to be put first. We join you today in saying enough is enough. ‘This isn’t Tesco, it’s the NHS.’