Should GP collective action become the new norm?

Dr David Turner considers whether various parts of GP collective action should become permanent in general practice

At a recent GP meeting in my area we discussed what collective action different practices have taken. It soon became apparent that far from a temporary ceasing of an activity as a way of making a protest to the Government, many of us believed that not engaging in certain things should just become the new norm.

Take electronic referral forms for example. It is hard to find a GP who likes to complete these hideous things. Interestingly, many consultants I have spoken to also hate them. It is easier, more accurate and far, far better medicine to write a letter explaining what is wrong with that particular patient and why they need to be seen. None of us who were at that meeting had any intention of ever going back to using electronic forms to refer patients – and as it is not in our contract, they can’t make us. So there.

Similarly, not calling ahead to the hospital to ‘refer’ an urgent patient to them, just sending the patient down with a letter is part of our collective action. And it is not one we intend to reverse, no matter how much money the DHSC do or do not throw at us. Apart from the fact that none of us have the time to hang on the phone for 20 minutes waiting for an on-call doctor to answer their bleep, we equally don’t need a grilling from a wet-behind-the-ears junior desperate to find a reason not to accept the patient. No, from now on we will be sending all acutely ill patients with a hospital letter explaining what secondary care needs to do for the patient. Yes, a bit like the letters we get back from them.

On that last point, who of us intends to go back to being lackies for secondary care? Who amongst us, when collective action ends, will voluntarily go back to doing ECGs for cardiologists and blood test monitoring for psychiatry for free? Will there be many in our ranks who wish to go back to following lists of orders from secondary care? I think not. I am afraid this change will be permanent.

Limiting the number of patients that can be seen in a day: protest or just common sense? Hospitals have always done it – and what’s good for the goose…

For too long primary care has behaved like the recipient of maltreatment in an abusive relationship. Finally, it seems like the worm may be turning.

Dr David Turner is a GP in Hertfordshire