Contract could spark resignations despite green light from Scottish LMCs

Some GPs have warned they are ready to quit the profession over the proposed new contract for Scotland, despite strong support for the deal at a special LMCs conference on Friday.

Around four out of five GPs at the conference in Clydebank, near Glasgow, agreed that the offer on the table for Scottish general practice addresses issues around workload, sustainable funding, attractiveness of the profession and risk for GPs and practices.

Polling at the event found that LMCs overwhelmingly felt the deal tackled these issues, following debates on the four themes and assurances from Scottish health secretary Shona Robison. Ms Robison told GP leaders at the event that the Scottish government would back the new contract with £100m in 2018/19, and sought to reassure rural practices that they would be protected.

Ms Robison also set out plans to boost GP numbers in Scotland by 800 over the coming decade - a 16% increase on the current total of around 4,900.

Read more
>
How the GP role will change under the new contract
> How the new contract takes away the burden of premises
> Rural GPs fear new contract could lead to 'extinction'
> Read the proposed Scottish contract deal in full

BMA ballot

Many GPs spoke out positively on the deal, warning that the status quo could not continue and urging their colleagues to grasp the opportunity offered through the new contract for increased resources for the profession.

Dr Stuart Blake, from Lothian LMC said: 'I've heard people say the proposals might create the conditions where practices might be crushed and want to hand back their contract.

'My observation would be that the current situation is crushing practices and the current situation is causing practices to hand back their contract. I think the sustainability of general practice is most in danger if we reject this contract and vote to stay with the status quo.'

GPC chair Dr Alan McDevitt said: 'I am delighted that LMC representatives have such confidence in the proposed contract. We need to adopt new ways of working and this contract sets us in a new direction.  I truly believe that this contract will help deliver a sustainable future for general practice in Scotland.

'The poll of the profession opens next Thursday and I hope that all GPs and GP trainees in Scotland will register to take part and make their views known.'

But GPs at the event also voiced strong concerns about the impact of the deal, and organisations representing GPs remain deeply concerned less than a week before a BMA ballot on whether to accept the package begins on 7 December.

LMC representatives raised concerns about whether local NHS boards would implement the deal uniformly, about how much practices would be able to rely on staff working in their multidisciplinary teams if they were employed by boards, about changes to the funding formula and other issues.

Resignation fears

A snapshot poll by the campaign group GP Survival in Scotland found that 7% of respondents intended to resign if the new GP contract went ahead. Overall 43% intended to vote 'no', 31% to vote 'yes' and 19% were undecided. Just 81 (around one in five) of the group's Scottish members responded to the poll, but it suggests that the Scottish GPC and Scottish government could face a battle to persuade the profession to back the deal.

Rural GPs also remain concerned about the impact of proposed changes to the funding formula behind the new contract.

After hearing from the health secretary and BMA leaders at the conference, Rural GP Association of Scotland (RGPAS) chair Dr David Hogg told GPonline: 'Our concerns about the workload allocation formula remain.

'However we welcome the positive and direct acknowledgement of [our] concerns. We are pleased that the Scottish government has recognised the anxieties of rural GPs about the lack of rural-proofing in the current proposal. However we will be pleased to engage - and assist - with measures to provide the safeguards and clarifications required to move forward with the proposals.

'Relocation expenses and golden hellos only work when there is a sustainable longer-term opportunity and is only helpful in a wider context of sustainable and supported rural practice.

'RGPAS recognises how important a new direction of travel is for the future of primary care in Scotland and we are heartened by Shona Robison’s response to our concerns. We look forward to working with the Scottish government to achieving greater clarity so that we can move forward from our current concerns.'

GP Survival chair for Scotland Andy McIntosh said the contract deal was 'not fit for purpose' in its current form, and that he believed the organisation's poll was 'an accurate reflection of current feeling regarding the proposed contract with a very clear division in the profession'.

He added: 'Our membership is made up from GPs over a very wide range of practices across Scotland from deep end practices to remote and rural. I firmly believe that both our poll and the very active dicussions taking place on our members group are accurate reflections of the current situation.

'Several members who are "gainers" under the new formula have still expressed that they intend to vote "no" as they feel that the contract as it stands is divisive and they have little faith that the proposed changes will improve things for anything other than a relatively small number of practices. I am unsure what the course is going to be nationally but our poll and others show a very clearly divided profession with very strong feelings on either side at a time when unity is vital.'

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