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Imposed changes to the GP contract – GP leader answers members questions

In a webcast and downloadable audio podcast, Dr Laurence Buckman, Chairman of the BMA’s General Practitioners Committee (GPC), answers BMA members’ questions about the potential impact on patient care and the profession of the Government’s decision to impose changes to the GP contract. Dr Buckman also explains what action the BMA is taking and how GPs can make their voice heard.

To download or view the four minute podcast or webcast please use the appropriate links on the right.

Background
In October 2007, the BMA entered into negotiations with NHS Employers, acting on behalf of the government, designed to extend GP opening hours in a manner that would sustain the high levels of patient care delivered by GPs. The BMA submitted a workable proposal that would have produced extended opening hours and guaranteed quality of service for patients.

The government refused to accept this offer and put forward a proposal that placed undue emphasis on extended opening hours to the detriment of improvements in quality clinical care to patients and stated that if the GPC did not accept the government’s proposal, draconian contract terms would be imposed upon GP practices without further consultation or negotiation with the BMA. The GPC felt it was unable to accept the government’s proposal and decided it would seek the views of all GPs. Subsequently notice of a more draconian imposition was given on 21 December 2007. If implemented, this imposition will put clinical care at risk as 135 points are removed from the Quality and Outcomes Framework. The government proposal and imposition is broadly the same in England, Scotland and Wales. It is likely that there will be differences in Northern Ireland where extended access is not a government priority.

The GPC utterly rejects this gun-barrel method of negotiation, which essentially asks the profession to accept one of two impositions; an unacceptable offer or even worse imposed contractual terms. Both scenarios would lead to a cut in GP practice funding that would have to be earned back through the provision of extended hours, but with the latter handing money to local Primary Care Organisation (PCO) control. The BMA will shortly poll GPs to seek their views on whether to accept the governments’ offer or face imposition of even worse terms. GPs should consider their decision prior to responding by contacting with Local Medical Committee or GPC representative to discuss the implications of accepting or rejecting the offer. It is intended that the poll will be able to determine GPs thoughts more fully by asking a variety of questions. A further letter will be sent to the profession prior to the poll to explain the implications for practices.

The GPC is concerned that the government’s negotiating tactics (in England) are part of a wider strategy to increase the role of the private sector in the future structure and running of general practice, by removing funding from existing traditional practices. Any such move would undermine the personal, list-based system of general practice that is so valued by the vast majority of patients. Whatever the outcome of the poll, it is imperative that GPs continue to engage in the wider strategy, including lobbying MPs and informing patients, to make clear the ultimate aim of the need to support and develop traditional general practice, and prevent the creeping development of privatisation.

Further details of the Government’s intended imposition plan and the potential impact on both GPs and patients can be found in a letter to the profession from Dr Laurence Buckman, Chairman of the BMA’s General Practitioners Committee, on 8th January 2008:
www.bma.org.uk/ap.nsf/Content/LBletter080108

A separate letter updating members on the situation in Scotland was sent by Dr Dean Marshall, Chairman of the Scottish General Practitioners Committee, on 17th January 2008:
www.bma.org.uk/ap.nsf/Content/DMletter170108

View further GPC information on the details of the Government’s imposed changes to the GP contract:
www.bma.org.uk/ap.nsf/Content/GMSchangesDec07

View BMA Press Releases responding to the Government’s announcement of imposed changes to the GP contract:
BMA response to the Health Secretary's letter to all GPs, 4 February 2008

New Year update from the GPC on GMS contract negotiations, 8 January 2008

BMA response to the government's imposition of a draconian contract on GPs,21 December 2007

Northern Ireland
GPs in Northern Ireland won't have to offer extended opening hours. The BMA's NI General Practitioners Committee has received a formal contract offer from the Department of Health, Social Services & Public Safety which will be discussed with all GPs in Northern Ireland at a series of roadshows at the following venues:

Each event will commence with tea, coffee and biscuits on arrival at 7.00 pm with a start time of 7.30 pm

• Southern LMC area – Tuesday 12 February – Canal Court Hotel, Newry
• Western LMC area – Monday 18 February – Mellon Country Hotel, Omagh
• Eastern LMC area – Wednesday 20 February – Stormont Hotel, Belfast
• Northern LMC area – Thursday 21 February – Dunadry Hotel, Antrim

General Practitioners Committee