GPs in Northern Ireland have sent a resounding message to health minister Mike Nesbitt by backing a vote of no confidence in him and the health department.
In a heated day of debate at the Northern Ireland local medical committee conference in Belfast on 15 November GPs also voted to look at options for exiting the general medical services contract and working outside the NHS.
There is also likely to be an escalation of collective action, with doctors calling for the BMA Northern Ireland GPs committee to draw up a further menu of options that can be legally implemented. As The Doctor has reported, GP partners have been taking collective action – such as limiting the numbers of patients they see in a day and refusing to do unfunded work.
The conference was titled ‘A wake or an awakening? What’s next for general practice in Northern Ireland following contract imposition’, which set the tone for a day in which many GPs sounded at the end of their tether. None more so than Frances O’Hagan (pictured above), chair of NIGPC. In her address to conference, she said it had been a challenging year and was only likely to get worse.
Piecemeal funding
‘From this time last year, when we had the minister standing here, it has been really challenging. And when the minister was here and delivered his speech, I knew I was in trouble. But, boy, I didn't realise just how bad it was going to get,’ she said. ‘So what do we need? Take us back to basics; I'm very clear what we need in general practice and we have said it all along, funding into core general practice, including indemnity for all GPs, and for our national insurance costs to be covered.’
She said the funding allocated was piecemeal and insufficient. ‘We asked for £80m, which is £39 per patient per year. And we were offered £1m. That is less than a penny a week per patient. How the heck is a penny a week for [each] patient going to give us any additional access? Like wake up and smell the roses!
‘This was on condition of us meeting 17 access targets, none of which was going to add access and none of which were going to provide a single extra appointment.’
There was little surprise when conference backed a motion of no confidence in the current minister for health. GPs are angry not only because Mr Nesbitt imposed last year’s contract on them but also because they feel he has shown them a lack of respect.
They also backed a vote of no confidence in the department of health and strategic planning and performance group. Belfast GP Ursula Brennan took particular issue with private care becoming ‘normalised’ in Northern Ireland because patients had to wait so long for treatment. ‘How can we have confidence in a system that allows that to happen?’ she asked.
Bare cupboard
The minister has repeatedly said that the cupboard is bare and that he cannot provide more money than has already been offered – he has also said his door is open and that GPs are an important part of his plan to shift to a ‘neighbourhood’ model of care.
Nonetheless, even GPs who describe themselves as socialist to the core were expressing doubts on the sustainability of a general practice within the NHS (or health and social care service as it is technically in Northern Ireland) and the ramping up of collective action looks a near certainty.
Speaking after the event, Dr O’Hagan said there was no doubt grassroots GPs were frustrated and angry about how they were being treated. From the evidence of the conference, she wasn’t exaggerating.
For an ‘as it happened’ account of the day, see @JenTrueland on X
For a more sensible summary of debates and outcomes, see @BMANI_GP