Dr Copperfield on why over half of England’s GP practices have not started taking collective action
I found myself getting nostalgic watching the Paris Olympics, and not just for my days as a professional break-dancer. It reminded me of London 2012 and going misty-eyed at the children bouncing on NHS beds in Danny Boyle’s opening ceremony.
Now, just hold that image, would you, as I take a swerve onto Pulse’s recent survey. It revealed that nearly half of England’s GP practices have started taking collective action. Which also means that half of England’s GP practices have not started taking collective action.
If I were health secretary, I’d be incontinent with joy: even when supposedly galvanised, GPs can’t summon the will to simply work to contract, let alone strike! And the excuses are so lily-livered: they’re waiting for the BMA to tell them what to do, or for the big boys and girls of the practice to return from hols, or for mummy to tell them it’ll all be OK, or whatever!! Pass the pads!!!
In fact, those limp rationalisations hide a much more profound truth, which we GPs are probably too embarrassed to admit. And it’s this: GPs continue to feel some strange but irresistible moral duty to prop up the NHS.
Stop sniggering at the back. I know this flies in the face of the tough-talking rhetoric from our leaders. But hear me out. When I was a houseman, I finished my first half day at 11pm. And I turned up on a bank holiday simply because it hadn’t occurred to me that I wouldn’t be expected at work. Youthful naivety, perhaps, but this work ethic and sense of duty was endemic. It soon became apparent to me that the NHS ran, to a large extent, on the goodwill of its workforce.
This attitude may have been diluted but it isn’t lost, certainly not in general practice. Even now, 40 years later, every GP I know logs onto the practice system well outside of contracted hours to prepare for the next day or mop up the previous one.
I’m not saying this is right or wrong. I’m just saying it’s a fact. And ‘working our contract’ would in fact mean ‘working a contraction’ in terms of what we actually do and how we see ourselves. It would require a massive attitudinal U-turn for many of us – which is, I suspect, the actual reason why the response to collective action has, literally, been half-hearted.
Maybe we’ll take a lead from the junior docs and decide we’ve been benignly insane to subsidise the NHS all these years. Besides, what do we want for this Olympian feat, a medal?
The sad and inevitable fact is that working to contract is a withdrawal of that goodwill. This in turn means the NHS could not possibly exist in its current form, and no amount of funding will replace what’s been lost. That might still be a price worth paying. But it does mean that in future opening ceremonies, there will be no children bouncing on beds. Because there will be no beds, and there will be no pride.
Dr Tony Copperfield is a GP in Essex. Read more of his blogs here
Pulse's survey on collective action
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