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Doctors in England were today slammed for threatening industrial action over being ‘asked to do the very basics’ of their jobs, amid a growing dispute between GPs and the Goverment.
Health Secretary Sajid Javid published proposals last week to give general practice £250million this winter to offer more in-person appointments and same-day care.
Under the plans, the NHS would publish league tables of how many face-to-face appointments each of the 6,600 surgeries in England offered — effectively ‘naming and shaming’ those that do not offer enough.
But the British Medical Association’s England GP committee yesterday rejected the proposals, as well as separate rules that would have them oversee the Covid vaccination exemption process and force the highest earning doctors to publicly declare their salary.
They will hold a ballot — at a yet to be confirmed date — on whether they should take industrial action over the plans by refusing to comply with them.
While it would not be an outright strike, the move could see thousands of doctors reduce the amount of work they undertake at a critical time heading into winter.
It is not yet clear what impact the industrial action would have on patient care, but it could lead to rejecting to see more people in-person, fewer visits to care homes and refusing to write certificates for people medically unable to get a Covid jab.
But Matthew Lesh, of the Adam Smith Institute think tank, told MailOnline workers are normally ‘dismissed’ when they fail to do their job, but GPs ‘find it outrageous’ that people want more face-to-face appointments. ‘Being asked to do the very basics of your job does not justify strike action,’ he said.
And Dennis Reed, head of campaign group Silver Voices, urged the Government and doctors to ‘get together and sort it out in the interest of patients’.
It comes as doctors said this week they have no capacity to play a major role in speeding up the rollout of Covid booster drives, because of the surge in demand for appointments post-lockdown.
GPs ‘out-and-out rejected’ Sajid Javid’s (pictured, right) £250million plan to give patients more face-to-face appointments, the British Medical Association claimed today. Pictured left: Dr Richard Vautrey, BMA GP committee England chair
The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP’s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary
Mr Lesh, head of research at the Adam Smith Institute, said: ‘Normally when a worker fails to do their job they are dismissed.
‘But somehow GPs find it outrageous that taxpayers, who are paying their salaries, are demanding that they provide face-to-face appointments.
‘This speaks to a broader systematic failure of the NHS to treat patients as important customers, rather than as an inconvenience with far too many demands.
‘It’s particularly absurd that GPs are threatening to strike over Government requests to actually see patients in person.’
Mr Lesh said the structure for incentivising GP practices — which are currently paid based on the number of patients on their lists — should be changed so they are paid per appointment.
Meanwhile, Mr Reed told MailOnline: ‘I would have thought there would be urgent steps from Government to convene a meeting with doctors to thrash this out.’
He said: ‘It’s going to be the patients that suffer the collateral damage if there is a bitter dispute between the doctors and the Government. And I’m afraid in all this hot air and emotion it’s the patients who are being forgotten.
‘The quite reasonable demand for the number of remote consultations to be reduced and the number of face-to-face appointments to be increased appears to have basically set this off.
‘There must be a lot of ill feeling between the doctors and the Government for this simple request for an improvement in service to promote such an action.’
Mr Reed said he would be ‘quite sympathetic’ to GPs if they were threatening strike action because they want to increase in-person appointments, but do not have the resources.
‘But they don’t seem to be saying that. They seem to be saying they don’t want to improve access for patients to GPs, which I find rather sad and disappointing,’ he said.
It’s ‘quite unusual’ for public service workers to take action because they don’t want to improve patient access, Mr Reed said.
He said: ‘I would obviously warn against any action that prevented diagnosis of serious conditions. And I can’t imagine doctors would want to take action that could actually harm patients.’
The number of GP appointments taking place face-to-face tumbled at the start of the pandemic when surgeries were told to see patients remotely where possible. But despite the country largely returning to normal, in-person visits are yet to climb back to pre-pandemic levels. The above graph shows the number of face-to-face GP appointments (red line) by month since the end of 2019
It would be ‘a type of Armageddon industrial action’ and ‘outrageous’ if GPs reduced their visits to care homes because those residents are the ‘most vulnerable and fragile in society’, Mr Reed added.
The Health Secretary’s plans — which triggered outrage among doctors — included extra funding for surgeries to boost their capacity for face-to-face appointments.
Before the pandemic, around eight in 10 appointments happened face-to-face, but just 58 per cent took place in-person in August.
The cash would go towards using locums and other health staff — such as physiotherapists and podiatrists — to increase same-day care.
Under the plans, the NHS would also publish a league table of how many in-person consultations each GP surgery has per month to ‘enhance transparency and accountability’.
But the BMA’s England GP committee rejected the proposals, because they ‘fundamentally failed to address the ongoing crisis in general practice’. It said it is ‘outraged by the deliberate, relentless denigration of GPs’.
The committee said the Health Secretary ‘ignored the expertise and experience of family doctors’ when setting out the plan and ‘patient care will suffer as a result’.
They called on surgeries to not implement the plans and pause efforts to recruit extra staff to increase in-person appointments.
The committee will shortly vote on whether to take industrial action over the plans, as well as the move to publish details of the highest-earning GPs.
The requirement, due to come into effect next month, would force doctors making more than £150,000 per year from the NHS to have their earnings revealed alongside their name.
The BMA said this has ‘no benefit to patients or their care’ and could increase aggression towards doctors, damage morale and worsen their ability to recruit and retain GPs.
Plans for doctors to write letters for people to medically exempt them from Covid jabs would also come to a halt if industrial action went ahead.
Doctors expect they would mainly have to write the letters for social care staff, who are required to be double-jabbed from next month to stay in their job, unless they are medically exempt.
The BMA called on ministers to work with GPs on a new contract that gives general practice more money, a ‘safer workload’, reduced bureaucracy and improved working conditions.
Dr Richard Vautrey, the chair of the BMA’s GPs committee, said: ‘GPs have been left with no alternative but to take this action.
‘All efforts to persuade the Government to introduce a workable plan that will bring immediate and longer-term improvement for doctors and their patients, have so far come to nought.
‘The Government has completely ignored our requests for a reduction in bureaucracy to allow us to focus more on patient care, and we are therefore encouraging doctors to withdraw from this bureaucracy themselves.
‘The ultimate outcome should be to end the current crisis in general practice, to properly support practices to manage their workload pressure, including safely getting through the backlog of care caused by the pandemic and deliver a safe service to patients, allowing time to create an agreed long-term plan to make general practice sustainable for the future.’
Liberal Democrat health spokeswoman Daisy Cooper said: ‘This shows the Government’s deliberately provocative plans to name and shame GPs has backfired.
‘Sajid Javid must now dial down the rhetoric and get round the table with doctors and patient groups to find a way forward.
‘It would be unforgivable if, as we enter a winter crisis, people are unable to access their local GP.’
A Department of Health spokesperson said: ‘GPs have done phenomenal work done through the most difficult 18 months in living memory.
‘We want patients to be able to see their GP promptly and in the way they choose. Our plan will improve access and drive up face to face appointments – it includes providing a further £250 million to GPs in order to boost capacity.
‘We are also cutting bureaucracy and GP teams will be given targeted support which will take pressure off staff and free up their time so it can be spent with patients.
‘The number of full time equivalent doctors in general practice increased between March 2016 and March 2021 and, last year, a record-breaking number of doctors started training as GPs.’
Meanwhile, Rachel Power, chief executive of the Patients Association, said: ‘A battle between GPs and the Government and NHS England does not help patients.
‘Patients want to see how the Government plans to support GPs and their staff so that primary care is able to give patients the access to care they need.
‘At the moment, GPs are being overwhelmed by the demand on them and this is resulting in patients suffering.
‘The focus should be on supporting primary care, making it a service people want to work in, and planning how to give patients the access they need.’
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