Report by Susie Bayley (observer) , Zoe Jane (lmc rep) and Hussain Gandhi (observer).
GP Survival attended the special LMC conference on Saturday. Zoe was there as an LMC rep for Humberside, and Susie and Hussain as observers and to man the (very popular!) GPS stall. To view the webcast go to http://www.bma.org.uk/lmcconference
Our feedback in brief:
The whole thing was like walking into a GP version of Prime Minister’s questions. The method of debating, making decisions, speaking, heckling – all archaic and in desperate need of reform. One of the problems was endless debating of the minutiae of motions. People opposing it because the word “may” was included when they wanted it to be “should”. Hugely frustrating. We could see how this then ties the hands of the GPC – rather than backing the principle behind motions such as reducing workload, or changing contracts to force the government to respond, we got bogged down in phrasing and words hence they weren’t always passed. We felt this sent the message that a) GPs are wet, b) we can’t organise a piss up in a brewery, and c) we don’t feel that strongly about it otherwise these would have passed. The “ but we would only get something worse replacing xyz” argument was used often to shout down perfectly good motions. The “we know what we can manage/what our patients needs” argument was also used, when the current state of affairs very much implies we as a profession have no idea what we can safely manage because we aren’t doing it now! The other difficulty was because of the format there was no right of reply. People stand, speak about the motion, raise points, are then contradicted/disagreed with by the next speaker and can’t discuss it as their turn has passed. The for/against are not alternated so you can have 3-4 people arguing against the motion in a row, then a few for it tagged on. There is some attempt at balancing the amount of for/against responses but it is difficult to understand at times.
Main contentious debates:
A frustrating 20 minutes to vote in the agenda. Confirmed the week before with a supplementary agenda, a challenge was made to scrap the suggested agenda and just debate the issues. Several newcomers to conference and observers felt this process was simply ‘bickering of the old guard’ which served no purpose other than to inflate egos. It was also apparent there was huge resistance to anything so drastic… It also set the tone for what is clear to be a procedure ridden process.
Below is a summary of the motions submitted. Please reference the agenda.
Opening speech by Chaand Nagpul – powerful message of support and a call for unification. We all felt Chaand gets the issues and challenges but is trying to steer a tanker in a circle. He was passionate and convincing. We hope to hold our GPC to put actions behind these words.
- 5. Passed in the main with caution regarding limit of core hours.
- 6. Motion proposed eloquently but challenged on wording and the prospect of stopping visits rather than inappropriate visits. Aside from i. passed in main.
- 7. Debated passionately however rejected on the possibility of the loss of independent contractor status.
- 8. Motion on use of physician assistants. Motion i- a consideration as a lifeline for general practice was lost, but remaining motions carried.
- 9. Looked at, student loans, training amendments and supporting Northern Ireland training. All motions aside from ii carried.
- 10. Not debated due to time restrictions.
Here was a break for lunch followed by a speech by RCGP Chair Maureen Baker. She gave a clear call for change including the immediate suspension of CQC but lacked in our view the same connection that Chaand had. She referenced being accused of scare-mongering by the media, similar comments that have been thrown at GPs in the past.
- 11. The motion was not passed despite powerful arguments by proposer Peter Holden. The feeling was a commission would not achieve much further information and existing evidence on some parts already exists.
- 12. Motion passed with comments about alternative methods of care like DevoManc however challenges made regarding ‘evidence’ to support need for 7 day routine working.
- 13. Motion passed with no actual argument again with a clear vote. #endCQC
- 14. Passionately debated and eloquently proposed by Stephanie De Giorgio. All motions passed I. The main except v. Some representatives cautioned the ‘what would replace’ revalidation element and used this fear to fail this motion. At this point the disdain was palpable in the room that the profession may be lacking the passion for action.
- 15. Well debated motion from both sides regarding issues on premises.
- 16. Many of the arguments on this key motion resonated on the use of numbers specifically changing to £200 to a percentage than a fixed number number. However motion passed overwhelmingly.
- 17. Again a motion debated hotly on the detail rather than the ideal. i and iii passed but it failed due to concerns this would hamper responsive arguments.
- 18. A motion focussing on the term reimbursement, but despite this passed unanimously.
- 19. A debate worthy of conference that raised positive and negative elements of indemnity cover versus crown indemnity particularly citing ‘out of date’ legislation by Peter Swinyard. Motion carried overwhelmingly.
- 20. The final motion which included as part 3 mandating the GPC to canvas GPs for undated resignations if no rescue package for General practice was obtained in the next 6 months. In this motion with 19 speakers old and new, faith in our representatives was restored. With passionate speeches by many several deserve mentioning. Most notable was Claire Bannon stating the motion did not go far enough, Russell Brown admitting being swayed to change his mind and now support the motion, Zoe Jane holding the GPC and our profession to follow through and unify to protect our peers and patients, and most emphatically Katie Bramall-Stainer delivering a Churchill worthy call to GPs ending with ‘if not now, then when’. To see this click here and watch from 5h 14m. Subsequently the motion was overwhelmingly carried ending conference with a powerful statement.
As observers one theme that came up several times was the use of the General Practice Defence Fund collected from voluntary levies from each LMC. Noted was comments of a lack of use of this fund and even comments that successive treasurers have prided on the growth of the fund. GP Survival are concerned about this lack of use of funds designated to help GP negotiators in their efforts and question why it is not being used for a clearly needed media campaign or redirected back to LMCs /practices on a large scale. As a result we will be asking for clarity on this matter from the GPC??
We received an overwhelmingly positive reception both at the GPS stall and each of us individually. A lot of members, and a lot of those who knew of us and wanted to know more. Comments from a whole range of “high profile” individuals, and at least 6 big LMCs. The message was the same. Keep pushing, keep fighting. We have to get involved and push for action. GP Survival will continue to champion the cause for GPs and would comment to all GPs to continue to push for change.
‘if not now then when, If not you, then who? ‘
GPSurvival apologises for an incorrect statement on an earlier version with reference to Chair of RCGP Maureen Baker’s speech which has been amended to reflect the original intended comment.