Why shouldn’t this collective action be the norm?

Editor Jaimie Kaffash questions the use of the term ‘collective action’ when GPs simply fulfil their contract

If you are a little confused about the collective action beginning today, I don’t blame you. None of the measures breach the GP contract, and there are good reasons for this – GP partners simply can’t afford financial penalties at the same time as having to pay staff and expenses.

Further confusing matters, the BMA has said that practices could undertake any of these measures at any time – they didn’t need to wait for the collective action. .

Equally, the measures are designed not to harm patient care. I can understand why the BMA is saying this, but Copperfield puts forward a great argument that GPs cutting work and it having no effect on patients isn’t a great look for GPs.

So with all that in mind, I am confused: why isn’t the BMA just advising practices to undertake all these measures, all of the time, regardless of any dispute with government?

Practices are under pressure, underfinanced and understaffed (despite GPs being out of work). I can’t think of any other businesses that would go beyond their terms of contract, while overstretching themselves and putting themselves at risk of burnout as a result.

The measures are all sensible. A lot of measures are clinically preferable: limit daily patient contacts, stop engaging with advice and guidance unless it is timely, and stop voluntary services that plug commissioning gaps at the expense of your core work. All of these would be advisable to maximise clinical effectiveness, as they allow GPs to give appropriate time to the patients they should be seeing.

The suggestion to stop rationing referrals, investigations and admissions is absolutely necessary, regardless of any collective action – it is a scandal that GPs are put in the position where this isn’t the norm already.

The others are all bureaucratic, and I think everyone would agree that precious GP time should not be spent on paperwork that isn’t absolutely essential.

NHS Confederation has claimed that the collective action would heap more pressure on A&E. But as Dr Fay Wilson rightly points out in the comments on our story, trusts should be scrutinised on why they are unable to handle GPs working to their contract.

In their defence, the reason is almost certainly that they, like primary care, have been grossly underfunded over the past 14 years, and there are gaps in the contracts of both trusts and GPs that mean the Government and NHS are expecting health bodies to do uncontracted work as a matter of routine.

By practices sticking to the terms of the contract, it puts the GPC in a powerful position in negotiations – the ability to say, if you want us to do the work you need us to do, you need to pay for it. If you don’t, you are putting A&E at risk, apparently.

This isn’t a criticism of the GPCE. I strongly suspect that this is what they are thinking, and this ‘collective action’ is a way of packaging it in a way that gives it a defined start, and allows the chair to make headlines about bringing the NHS to a standstill.

I also hope, however, that we see the term ‘collective action’ being slowly phased out, replaced by the term ‘GPs doing what they are supposed to do’. Because I would be pretty certain that this will lead to an influx of funding pretty soon. 

Jaimie Kaffash is editor of Pulse. Follow him on X @jkaffash or email him at editor@pulsetoday.co.uk