LMCs Special Conference Somerset LMC Chairman commentary
This Conference was convened after a call by the appropriate number of LMCs, not in place of but as well as the annual two day May conference. Its purpose was to debate actions that the GPC could take to help the situation in General Practice at the moment. It was hence a fairly animated and heated affair but was suitably manged so that it did not turn in to a ‘whinge-fest’. In fact the quality of debate was very high and contrary to the usual 40 motions tabled in one day, there were just 16 to enable as many GP representatives to speak as possible. Somerset had no main motions tabled to speak to and we used the opportunity to listen and digest and inform our newer conference attendees about the format of the day ready for their launch in May.
We started with a debate about the Agenda and its content - whether it should be abandoned and we just have a free microphone discussion (with the inevitable long queues) to hear more views on untabled motions. There followed one of the first of many ‘emergency’ speakers – normally we only get one or two during the whole conference– but I had lost count of these by the end of the day. All business stops when these are presented whilst the emergency speaker responds to a factual matter in the debate under way and is not allowed to give an opinion. It is fair to say that this was stuck to variably throughout the day despite the best efforts of the Chair.
Chaand’s rousing opening speech got a justifiable standing ovation and gave a good summary of the challenges in Practices at the moment. The focus of the day was on the fact that it is not safe for patients for us to carry on as we are and the government must help. It is worth watching on the web cast if you have time. Interestingly he mentioned that the most motions that were submitted regarded CQC. He stated that General Practice is in a ‘state of emergency’ and that the day was about ‘solutions’
Debate then started and the bullet points below summarises the outcome of balanced and lengthy debate.
Conference supported separate contractual arrangements for Medical Certification and Care Homes (this doesn’t mean that GPs won’t still be contracted to do them). Conference particularly liked one speakers comment that ‘General Practice was funded as a food bank’ whilst patients are given the idea that it was an ‘all you can eat diner’
Conference voted against a motion to move away from the independent contractor status. Conference was no doubt persuaded by one speaker saying that she was ‘constantly disappointed by the size of Jeremy Hunt’s package’
The principle that Physician assistants could be the solution for General Practice was voted down although many speakers in this motion and the last made the point, with which your correspondent agrees, that the possibility of these and salaried options in Primary Care should be pursued. Those motions were partly lost because of the intransigent nature of the wording of the motion (and indeed of Conference – such was their mood) and will no doubt be brought back (as any motions can) for consideration by the Agenda Committee for May.
GP training – a motion to encourage the Government to write off some GPs student loans to encourage trainees into the profession was passed as was increasing the number of training posts in Northern Island where there are two applicants to every post.
Motion 10 got lost to this day due to lunch
After which Maureen Baker of the RCGP spoke. Whilst not acknowledging the fact, she said very much what Chaand had, which led us to believe that perhaps she had not been present in the morning but at least both organisations were united in their approach. The biggest round of applause was when she referenced the Junior Doctor strike and successful political action so far. There were several references to this throughout the day all similarly received and it was good to see the profession so united. Indeed at the end of the day there were pickets of support outside the Conference room including Junior Doctor reps one of whom told me ‘we are behind you all the way’ This has to be the only way forward.
Conference voted against convening a new Commission to look into the future of the NHS feeling that it would hold any change up and we want action….now!
They voted that new models of care had to have the Partnership Model at its centre. Interestingly, there were many young doctors speaking during the day both salaried and partners. They all emphasised that the mantra of most young GPs not wanting Partnership was true only in the short term was not supported by the surveys. The truth is they make this choice either because they see it as a development following gaining experience or they were waiting until they saw what happens over the next few years to the Partnership model. Those who wished to stay as Salaried as a lifestyle choice were still passionate about General Practice. Amongst Conference it was felt that having options in the career was essential but set around the independent, Partnership model.
There was unanimous support for a review of CQC funding, function, outside regulation…everything
Appraisals. It was agreed that these needed to return to a formative process but a motion to abolish revalidation was narrowly lost mainly due to the fear of what would be in its place...exams?
Premises. A demand for a ‘buyer of last resort’ (for ‘last man standing’ situation) was strongly supported
A call for an increase in Practice funding was supported. GPs now cost less that the annual rate of insuring a tortoise (it was very amusing hearing of the variety of pets that speakers had looked up to insure) and should at least be £200 per patient per year.
Contracts. Conference called for an end to annual negotiation on our contract feeling that a longer term contract would give more stability and also insisted on a truly independent Doctors and Dentist review Body
Conference wanted full and proper reimbursement of GP expenses and encouragingly. The GPC said they hoped to have ‘very good news, very soon’ about this
A call for Crown Indemnity was overwhelmingly supported
THEN THE BIGGIE. A whole hour of discussion hearing from all 19 speakers. At the end of which Conference became even more militant and emotional and carried the following overwhelmingly
‘That Conference instructs GPC that should negotiations with government for a rescue package for General Practice not be concluded successfully within 6 months of the end of this conference:
action s that GPs can undertake without breaching their contracts must be identified to the profession
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
The GPC should canvass GPs on their willingness to submit undated resignations.’
Make no mistake, this is a mandate for the GPC to follow the Junior Doctors Committee and look at industrial action. Whilst sending in undated resignations will seem to be an outdated thing to do it will, if the majority of GPs follow it, send a strong message to government that enough is enough. Chand summarised the day by saying that he hoped it would be the beginning of the recovery of General Practice
It is rare that a ‘normal’ LMC rep gets a standing ovation but it happened at this Conference. A new young, female partner asked Conference to help her continue in the next 20 years in general practice and that the time had come to stand up for ourselves. Her question was ‘if not now, when?’
I would ask the same question of you all and should it become necessary that the GPC proceeds to such action your LMC would ask for unanimous support of patient safe measures that can be undertaken to get the help we need for our Practices and most importantly our patients.
Dr Sue Roberts