GPs on strike?

With the whole NHS seemingly crumbling, it wouldn't be a stretch to say that primary care was valiantly holding up a failing system. Emergency departments with long waiting times, paramedics, physiotherapists and nurses striking, junior doctors likely going to strike, waiting times for elective procedures at all time highs - there is only so much this system can take. 

Recently, there was a negotiation between NHS England and the GP division of the BMA regarding the 2023/2024 contract, deciding terms and funding uplifts. The BMA walked away from the negotiation disgusted with the potential terms of the contract, rumoured to include mandated patient access to GP records and funding linked to GP access. Most important is no additional investment to help with the rising cost of living, which includes a raise in the national minimum wage, rising utility bills and pay rises for all existing staff. 

Talks about what the BMA want is scrapping of the QOF system, payment by activity where payment is done for work done rather than patient's on your practice books, workload caps and withdrawal from the PCN DES. All these potential ideas are quite radical but the most likely one that we will see is the scrapping of QOF as its been slowly been eroded anyway as the years have gone on. 

The government may just impose their version contract unilaterally which will then give us GPs two real choices - accept the terms or go for industrial action such as striking. Many groups currently are striking, the nurses have held industrial action a few times now, the paramedics have striked and the junior doctors are about to do a 72 hour walk out. How would a GP strike work though? In the hospital, the consultants can step in for the junior doctors so there will be at least be some cover, in GP land, there is no cover. It would be up to the urgent care or Out of Hours provider to cover primary care, and it would depend if any GPs would stop work on that day. 

Public support will likely be key but with the Daily Mail on a GP witch hunt, the populist opinion with the public I fear will be unsympathetic. I have a sneaky suspicion that the government may unilaterally impose their contract at the same time as they decide that high-earning GPs have to publish their wages. It will paint a bad picture that high earning GPs (and will be more that usual due to the covid vaccination money) are striking to get a better 'deal' on their contract. They won't understand that was a one off, that profits are likely a lot lower now, and that it is likely to drop in the coming years. I think that striking is a powerful tool to use, but it is a hard one for GPs to really wield.