The worst of all worlds – that’s the only way to sum up the disgraceful decision by more than 8,500 GPs to vote for industrial action ahead of negotiations with the Government over new contracts.
The impact on patients will be immediate, at a time when they are already faced with a dire service. The impact on hospitals is likely to be even worse, as patients seeking treatment for minor ailments crowd into A&E departments, or dial 999, heaping pressure on to an ambulance service already at breaking point.
It’s counter-productive and unnecessary. GPs, who have become progressively more unpopular since the massive disruption caused by Covid, are squandering whatever public support they have left. As a retired family doctor, this makes me genuinely angry.
GPs will now be able to choose from a series of actions set out by the British Medical Association (BMA). Several of them are downright dangerous to patients, despite claims by the doctors’ union that by implementing them, GPs can ‘support a safe service for their patients and their practice team’.
The impact on patients will be immediate, at a time when they are already faced with a dire service
The most alarming of these proposals, and the one that is top of the BMA’s list, is to ‘limit daily patient contacts’ to a ‘safe maximum of 25’. That might seem a reasonable ceiling, if you imagine that it means 25 old-fashioned consultations averaging ten minutes each – that’s more than four solid hours of work.
But the reality might be 25 repeat prescriptions, done in a few minutes with a stroke of a pen.
Other suggested forms of action are for doctors to stop supporting voluntary services, and to refuse to sign up for improved online services that make it easier for patients to access information and support via the internet. All these are serious steps, calculated to cause major disruption within the NHS, at untold cost to the public. They should be a weapon of last resort, not an opening salvo.
If GPs concentrated instead on explaining their concerns, they could win widespread public backing.
One significant BMA demand is for changes to the current system of referrals by which, for example, patients with suspected cancers are sent to specialist consultants. It is wrong for this system to have an upper limit, as it currently does, with referrals rationed.
The new Government has been in place less than a month. The BMA is in a powerful bargaining position, since it clearly has the overwhelming backing of its members. The vote alone ought to be enough to make Health Secretary Wes Streeting aware he has no choice but to make concessions.
But the BMA is acting as though the Department of Health has vowed never to surrender. GPs are being warned that the fight could take many months, with industrial action dragging on long past Christmas. It makes no sense.
Labour is largely responsible for this crisis, because of the shocking speed at which it caved in to junior doctors – who were granted a pay rise of 22.3 per cent last week.
Health Secretary Wes Streeting ought to be aware that he has no choice but to make concessions. But Labour is largely responsible for this crisis for caving in to junior doctors
The Government is already committed to increasing GPs’ pay by 6 per cent, but this has plainly failed to satisfy the BMA – despite the fact that the average full-time general practitioner partner’s salary is more than £150,000 a year, with some able to earn up to £700,000, according to figures from the NHS Business Services Authority.
Getting an appointment to see a family doctor is already stressful and frustrating: it usually involves an 8am phone scramble as slots are made available, often two weeks in advance. Elderly and disabled patients, often the ones who need the service most, are at an automatic disadvantage.
Public mistrust of GPs will surely increase if we see doctors in the NHS working to rule but also moonlighting in private practice. This will deepen the perception of a two-tier health service, where those who can afford to pay extra get preferential treatment.
Already, Britain has become accustomed to a situation that was unthinkable just a few years ago, where patients see the health service as a sort of lottery – to get a GP’s appointment, you either have to be lucky or well-off enough to purchase a golden ticket.
The new Labour Government granted junior doctors a pay rise of 22.3 per cent last week
That leads to a breakdown in the unwritten contract between public and healthcare workers. Many people feel that they have to manipulate and cheat the system to get any treatment at all.
Not so long ago, the ambulance service was regarded by almost everyone as a lifeline for true emergencies, such as strokes and heart attacks. These days, I frequently hear anecdotes of people dialling 999 and exaggerating their symptoms in order to get a paramedic to treat a trivial injury such as a twisted ankle.
The result is queues of ambulances outside A&E, unable to offload patients, while people with life-threatening conditions are left to wait for hours.
If that gets much worse, we will effectively lose the NHS as we know it altogether. GPs are taking a shocking and pointless risk, pushing the whole system closer to complete destruction when they’re already in a winning position.
‘Disgraceful’ is too weak a word. They are betraying us all.
