Northern Ireland LMCs vote for 'nuclear option' of mass GP resignation

GP leaders in Northern Ireland have voted to press ahead with plans for mass resignation, warning that this drastic action is now the only way to save general practice from destruction.

Dr Arnie McDowell: mass resignation is the only way to save general practice
Dr Arnie McDowell: mass resignation is the only way to save general practice

Undated resignations have already been submitted to GPC Northern Ireland (NIGPC) by some practices across the country, including by NIGPC chair Dr Tom Black's practice, GPonline has learned.

LMC representatives at the 2017 Northern Ireland LMCs conference in Belfast on Saturday backed by an overwhelming majority a motion calling on GPs to 'move ahead with practice undated resignations as this is the only way to save general practice in Northern Ireland from the destruction of the service by our department of health'.

In his opening speech to the conference, Dr Black warned that 20 practices or more - around 6% of practices in Northern Ireland - could collapse within a year.

GP crisis

Calling on LMC leaders to back the motion, Dr Black said: 'Are we holding a gun to their head? Yes. Do we have to pull the trigger? Yes.'

He said NIGPC was calling for investment equivalent to the GP Forward View in England - pointing out that funding per patient was set to rise to more than £200 per patient in England while GPs in Northern Ireland receive closer to half that amount.

He told LMCs that senior health service officials in Northern Ireland believe that general practice would 'just trundle on' with or without a rescue package of funding.

'The destruction of the GP service in Northern Ireland is assured unless we fix it,' he said. 'If it wasn’t for the collapse of the executive, there would be a different excuse. We are a priority...just not this year’s priority. We are here to save the service for our patients.'

Proposing the motion, Western LMC's Dr Arnie McDowell said general practice in the country was facing 'destruction by neglect'. The service was now 'reaping the whirlwind' of a decade of failure to implement measures to save the profession, with warnings about GP trainee numbers and workload repeatedly ignored.

'Is there any doubt gen prac needs to be saved?' Dr McDowell said. 'There is not. Is resignation the only way? I have to say it is. With regret.

'We have won the argument. Everyone knowws there is a crisis and what needs to be done. But are we any closer to achieving a genuine rescue package? I don’t think so. The time has now come to move ahead and implement this strategy.'

He told the conference: 'The alternative is for this group of GP leaders to preside over the terminal decline of general practice in Northern Ireland.'

Eastern LMC's Dr David Ross told the conference that the only alternatives to a controlled, mass resignation were doing nothing, watching practices collapse one by one, or resign one by one.

He said mass resignation was the only viable choice. 'We have to do this. I hope by doing this we deliver the change we need. I hope we never come to the point where we open up with a credit card machine at the front desk, but I don’t see an alternative option.'

Western LMC's Dr Martin McCloskey acknowledged that some 'very committed' GPs were not prepared to take such drastic action. 'It's not that they are wanting to protect their income or their practice - they are committed to patients and they find the idea of making care more difficult for patients hard.

'But we are in such a dire position - we have ben allowed to get into such a dire position - that this almost amounts to collusion. The service isn’t going to survive. There are an awful lot of practices that think they are very stable and safe, but one illness, one car crash, one emigration to Australia and they are in trouble. This is a big ask but I think it is the only choice we can make.'

Eastern LMC's Dr Ursula Brennan warned GPs to think carefully before backing mass resignation - warning that although some LMC representatives would be retired in five years, she and many other GPs would not. 'Is this really the only way to save general practice,' she asked. 'It is a nuclear option.'

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