Can GPs take industrial action and how might it affect patients?

Family doctors have moved towards holding a ballot on industrial action in a row over in-person appointments

The British Medical Association’s GPs committee (GPC) has voted to reject an attempt by the health secretary, Sajid Javid, to force family doctors in England to see any patient who seeks an in-person appointment. Significantly, the GPC, which negotiates family doctors’ conditions with the Department of Health and NHS England, has also decided to move towards holding a ballot on industrial action.

How did we get here?

A key part of the motion that the 57 members of the GPC agreed as their response to the government’s plan made clear that they were “outraged by the deliberate, relentless denigration of GPs by government, NHS England … and certain quarters of the media”.

The BMA and the Royal College of GPs are furious because they believe that recent statements by Javid, Jacob Rees-Mogg, the leader of the Commons, and the prime minister’s official spokesperson wrongly give the impression that family doctors are not working hard enough and are penalising patients and risking missing the chance to diagnose illness by not seeing them face to face.

What happens next?

The BMA’s ruling council has to rubberstamp the GPC’s decision. But the union hopes its move will prompt Javid to abandon the plan before any industrial action occurs. It is urging him to instead negotiate a new contract for GPs that would significantly reduce their workloads, which have been rising in recent years for various reasons, including the ageing and growing population, hospitals asking GPs and their teams to take over the care of discharged patients, and the shrinking number of full-time GPs.

Can GPs take industrial action?

They could, subject to the result of a ballot. But it is unclear what form that would take because family doctors are unlikely to stop seeing patients, given their key role as the initial way people with symptoms are assessed, diagnosed and treated, and as gatekeepers to wider NHS care in hospitals.

How might industrial action affect patients?

Minimally. The motion that the GPC passed would limit industrial action to just two areas. Family doctors would not agree to release details of their earnings (NHS England wants to force anyone earning at least £150,000 a year to declare it from next month) and they would not get involved in the issuing of Covid medical exemption certificates, which people who remain unvaccinated on medical grounds will need in order to work in social care, and potentially the NHS too.

What will the practical impact of the BMA’s move be?

England’s 6,600 GP surgeries could refuse to abide by Javid’s order on in-person consultations, which means patients would not get the right to be seen that way. They could also refuse to hand over details of how many patients were seen in person, to thwart Javid’s plan for what the BMA fears will be “a league table of shame” for doctors who see too few.

It could also lead to practices halting the recruitment of the 26,000 allied health professionals – pharmacists, physiotherapists and mental health workers – that ministers want to see hired by 2024 to help take the pressure off GPs. So far about 10,000 such posts have been filled.

Practices could resign from their local primary care network (PCN). That would then free them of contractual obligations to, for example, visit care homes at agreed intervals to check on residents’ health or undertake patients’ medication reviews.

What does the BMA want?

For Javid to drop his plan and enter talks on a new strategy that would reduce the growing pressure on GPs. The Department of Health did not immediately respond to the BMA’s move.

Contributor

Denis Campbell Health policy editor

The GuardianTramp

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