GP leaders in Wales have voted in favour of instructing the BMA to plan and pursue a contract dispute with the Welsh Government ‘via all means’.
At their annual conference on Saturday, representatives from Wales’s LMCs passed a motion asking the union’s Welsh GP committee to ‘develop a plan to pursue contract dispute’ with the Government.
The motion also added that given the ‘difficulty’ with withdrawing core contractual services, the committee should liaise with other GPC UK component committees to ‘jointly discuss plans across the UK’.
The conference called on the Welsh Government to sign up to a ‘realistic timetable’ for GP contract negotiations, with ‘set deadlines’, to ‘avoid’ the situation where a contract meant to come into effect in April is still being negotiated in October.
Negotiations for the 2025/26 GP contract in Wales are still due to take place. Only in January the GPC accepted a contract offer for the 2024/25 contract, including a £23m ‘practice stabilisation payment’ and an assurance from the Government that new negotiations for the next financial year would begin as early as possible.
The LMC conference also voted in favour of a motion directing GPC Wales to ‘actively’ develop alternative plans to GMS for the future of general practice, looking at ‘all potential options’.
‘Whilst GMS is clearly the most cost effective and professionally satisfying way to deliver general practice, the current climate suggests it is being intentionally starved with the intention of making it impossible to continue,’ the motion added.
GPC Wales chair Dr Gareth Oelmann told the conference that he hoped the Welsh Government ‘finally understand’ the ‘fragility’ of GMS and the ‘anger’ of the profession.
However, he added that should the Government not cooperate in agreeing an improved GMS contract for 2025/26, the GPC is ‘fully prepared’ to consider a dispute.
It follows a referendum of the profession last year, which saw almost 99% of Welsh GPs voting in favour of rejecting an initial contract offer for 2024/25.
Dr Oelmann told the conference: ‘After our referendum, a substantial additional in-year funding quantum was offered, which must be seen as a welcome encouragement for the profession in Wales. Your united voice has been loud and unequivocal. Together you forced the Welsh Government to reflect on and vastly improve its original offer.
‘While this settlement does not resolve every issue, it provides a solid foundation upon which to build. As part of this deal, the Welsh Government has assured that negotiations for the 25-26 GMS contract will begin as early as possible.
‘Conference, we must give credit where it is due and congratulate the new cabinet secretary for setting a new tone and direction to negotiations – this must lead to an early and improved GMS contract in 25/26.
‘But should this support not be forthcoming, we are fully prepared and will not hesitate to approach the profession again to seek your support for collective action. The recent experience of this deal demonstrates what a united profession can achieve.’
At the conference, LMC leaders also called on the Welsh and UK Governments to ‘find a solution’ to mitigate costs resulting from the Autumn Budget changes, as these are ‘an existential threat to general practice as we know it’.
They also passed a motion calling for a ‘properly funded’ national obesity service to assess, prescribe for and monitor patients on weight loss medication, without placing ‘additional strain’ on general practice.
And a motion demanding a change in regulations to ensure that GP partners who hold a GMS contract are ‘required’ to regularly provide clinical sessions in their practices was taken as a reference.
Health secretary Jeremy Miles gave a speech at the conference and acknowledged that as more diagnostic and other procedures move out of hospitals and into community settings, resources will need to move too.
He also said that GPs will be ‘supported in providing continuity of care’ and that health boards will be required to declare and increase primary care spending to support this change.
He said: ‘It is vital we work together to address the pressures in our NHS by improving access patients have to the care they need, and the flow through our system.
‘The role of GPs is fundamental to being able to bring the system back into balance. This is not about general medical services doing more and more but about designing a way of commissioning more services in a primary setting, in local communities but at a scale which is viable and sustainable.
‘GPs play a crucial role in their communities. I want to work with them to develop a primary and community care offer that values the skills and expertise of general practice and gives GPs the tools to thrive and delivers the care patients need closer to home.’
Last month, the Welsh Government said it will not increase the share of NHS funding spent on general practice until hospital waiting lists are ‘brought down’.
The motions in full
Conference believes there is an existential crisis enveloping British General Practice and GPCW should:
i. Develop a plan to pursue contract dispute with Welsh Government via all means
ii. Given the difficulty with withdrawing core contractual services liaise with other GPC UK component committees to jointly discuss plans across the UK PASSED IN ALL PARTS
Whilst GMS is clearly the most cost effective and professionally satisfying way to deliver general practice, the current climate suggests it is being intentionally starved with the intention of making it impossible to continue. In this context, conference directs GPC Wales to actively develop alternative plans for the future of general practice in Wales, looking at all potential options PASSED
Conference calls for Welsh Government to sign up to a realistic timetable for GP contract negotiations, with set deadlines, to avoid the situation where a contract meant to come into effect in April is still being negotiated in October. PASSED
That this conference:
i. notes the obesity crisis in Wales and the inadequacy of current NHS weight management services
ii. is concerned about prescribing practices of weight loss medications in the private sector and the governance of such practices when professional responsibility is passed to the GP
iii. notes the unprecedented pressure on primary care due to unresourced work fuelled by the significant rise in demand for weight loss medications
iv. calls for a properly funded national obesity service to assess, prescribe for and monitor these patients without placing additional strain on general medical services PASSED IN ALL PARTS
That this conference:
i. is concerned that recent budget changes including the rise in national minimum wage, national living wage and employers’ national insurance contributions, are an existential threat to general practice as we know it
ii. calls on Welsh and UK governments to find a solution whereby this can be fully mitigated as a matter of urgency with adequate funding to cover the above additional expenses PASSED IN ALL PARTS
That this Conference:
i. is concerned by the number of GP practices in Wales with GMS contracts held by GPs who perform no clinical sessions in those practices PASSED
ii. calls for all GP partners to undertake a minimum number of clinical sessions in their practice annually, including face-to-face appointments, while appropriately accounting for circumstances such as parental or sick leave TAKEN AS A REFERENCE
iii. calls for Health Boards to refrain from awarding multiple GMS contracts to the same individuals who are unable to provide clinical care across all of their practices TAKEN AS A REFERENCE
iv. asks for a change in regulations to ensure that GP partners awarded GMS contracts are required to regularly provide clinical sessions in their practices TAKEN AS A REFERENCE
Source: BMA
