THE BMA’s annual conference has called for restoring pay to 2008 levels and for GPCEngland to organise the withdrawal of GP practices from Primary Care Networks (PCNs).
The Annual Representative Meeting (ARM) of the British Medical Association (BMA) took place in Brighton from 27th to 29th June and was largely in-person for the first time in three years.
The important issues – pay to keep up with inflation and the threat of Primary Care Networks (PCNs) against the independent contractor status of GP practices, caused lively debate.
However, the ARM did not commit BMA Council to organising any immediate specific industrial action to put these demands into practice.
Motion 17, from Manchester and Salford division, on Monday morning was proposed by Emma Runswick, junior doctor, and member of the North West Regional Council and BMA council.
The motion stated: ‘That this meeting notes with horror that all doctors pay has fallen against RPI since 2008 to the tune of up to 30%. This represents a career earnings loss amounting to millions of pounds for each of us. We mandate the BMA to achieve pay restoration to 2008 value for its members within the next 5 years and to evidence its progress against this aim at every ARM until restoration is achieved.’
She said: ‘In real terms, junior doctors are down around 25%, SAS doctors around 15%, GPs a quarter, and consultants over 30%. This has been a deliberate choice by governments starting from the banking crash to make us pay for crisis after crisis we didn’t create.
‘We should not wait for things to get worse. All of us deserve comfort and pleasure in our lives. Pay restoration is the right, just and moral thing to do. But it is a significant demand and it won’t be easy to win. Every part of the BMA needs to plan for how to achieve this.’
She added: ‘I’m not foolish, I know that’s it’s likely to be that industrial action will be required to move the government on this issue…Do not be tempted to accept a pathetic future for our profession. We are worth more.’
Against the motion, was Anna Athow from Enfield and Haringey division. She said: ‘Junior doctors are on record for asking for a 22% pay rise, with a ballot within 6 months, by early 2023.
‘ARM we should be supporting them today, not saying we will be begging the government for the next five years, with annual reviews at ARM, to restore us to the 2008 levels of pay. This uplift of pay is needed right now!
‘There is a global economic crisis with trillions of dollars of debt due to printing of paper money, and a massive energy crisis. Inflation has gone from 6% in January to 11% now, in five short months – and it is continuing to go up.
‘Now is the time to fight. Good for the RMT! They’ve taken a stand and have organised national strike action, against a 2% pay offer and against compulsory redundancies. (applause)
‘Many other sections of workers are balloting for pay rises linked to inflation; teachers, civil servants, postmen, and airport workers. The barristers come out this week. The Royal College of Nurses is demanding an inflation-linked rise plus 5%.
‘Now is the time for the doctors to ballot alongside the Junior Doctors and other sections of organised workers. NHS staff are leaving the NHS in droves, because of overwork and burnout. But also because they cannot afford to live. We need a proper pay rise in order to save the NHS.
‘Please oppose this awful motion which condones sitting on our hands and doing nothing for five years. This is a sell-out motion.
‘I put in an amendment to this motion, to remove the five-year goal and replace it with six months, but the agenda committee turned it down.’
Junior doctor, Joanna Sutton-Klein, speaking for the motion said: ‘Junior doctors are leading the way and we want you to get in. It is outrageous that our pay has been cut by 30%, while £37bn has been wasted on Test and Trace and mortgages are going up. The richest have achieved obscene levels of wealth.’
‘Some people might think that the demand for over 30% pay restoration is too high. They might think it is outrageous. But I’ll tell you, what is outrageous is that our pay had been cut. It is sensible that we demand it back.
‘Last month, binmen in Manchester won a 22% pay rise. Two weeks ago Gatwick airport workers won a 21% pay increase. And in March cleaners and porters at Croydon hospital won a 24% pay rise.
‘Those workers got together and used a key tool that trade unions have – the ability to collectively negotiate and collectively withdraw our labour. We should use our trade union power. ….Vote for this motion. See you on the picket lines.’ She was warmly applauded.
Speaking against the motion, Kevin O’Kane, Consultant London Region, said: ‘Members of the Criminal Bar Association are taking industrial action. This motion sends a very different message. We’re giving them five more years to sort out doctors’ pay. This government is on the ropes. The NHS is on its knees for lack of doctors. This is a five-year flaccid fudge.’
There were two more brief contributions. Chaand Nagpaul, Chairman of Council commented: ‘No one has spoken against pay restoration within five years. The stretch to five years could be this year. Those speaking against were speaking on a technicality.’
In her reply, Emma Runswick said: ‘Pensions are deferred pay. I proposed the ballot in 2023 … I absolutely want us to win this now. You’re going to need some planning – and might need a phased number of years.’
The motion was voted through with a big majority and great enthusiasm.
On Tuesday morning, Motion 41, from London Regional Council, was taken first in the General Practice Section:
‘That this meeting supports GPs fighting to defend the GMS contract and independent contractor status. The long-term GP-patient relationship and the right for GPs to control their workload in a safe way, is essential for the future of general practice.
‘We applaud the South Staffordshire motion passed at the 2021 LMC conference which called for GPCE (General Practice Committee of England) to negotiate the end of the Primary Care Networks (PCNs) from 2023 as they ‘pose an existential threat to independent contractor status’.
(i) calls on GPC England and the BMA to organise the withdrawal of GP practices from the PCNs by 2023.
(ii) calls for PCN funding to be moved into the core contract.
(iii) instructs GPCE to act upon the GP ballot of 2021 and to organise opposition to the imposition of the new contract including industrial action if necessary.
The proposer was Dr Jackie Applebee, GP and Chair of Doctors in Unite.
She said: ‘With respect to the GMS contract (i.e. the core General Medical Services contract) I wouldn’t have started from here, but we are where we are and need to defend General Practice from vultures such as Centene who would asset strip us into oblivion. I believe that the small business model of General Practice is flawed. It prevents GPs from organising and the stresses of running the business only add to those of the increasingly intolerable clinical workload.
‘We cannot trust this government to protect General Practice, or indeed the wider NHS. They have been in power for 12 years, but things are only getting worse.
‘In an ideal world we could relinquish independent contractor status and be employed by a publicly funded, publicly provided, NHS, which is properly planned and not fragmented and disjointed by the nonsensical rules of the marketplace. However, we are not in an ideal world, and in this climate the independent contractor status at least gives GPs some control over their working environment.’
In response to the discussion, Jackee Applebee said; ‘With regards to industrial action, the landscape is changing. Even the barristers are taking action. A 30% pay rise would bring us back to where we should be. We have to have the courage to fight for ourselves.’
The Motion passed in all parts; (i) 67%FOR ; (ii) 64% FOR; (iii) 57% FOR
The chair of the Representative Body (RB) confirmed that the RB can instruct the GPC to act.