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UK GPs’ historic collective action ‘serves as a warning’


Chelsea Heaney


9/08/2024 3:01:17 PM

GPs have started a work-to-rule action that could go on ‘indefinitely’, leading some to ask if the same thing will happen in Australia?

A doctor sits at a desk with his head in his hands
The British Medical Association says it has been left with no choice but to take drastic action as general practice remains ‘broken’.

Amid growing fears Australia’s healthcare system is falling into line with the NHS’s failings, thousands of GPs in the United Kingdom have launched unprecedented industrial action in a desperate attempt to secure better funding and conditions.
 
The British Medical Association (BMA) and its members have started a collective action, after 99% of GPs rejected a 1.9% funding increase.
 
It is a decision which could see some UK GPs putting a cap on their daily patient numbers or changing patient data sharing arrangements.
 
There are now widespread fears the work-to-rule action will cause disruptions across the already overburdened NHS, with BMA GP Committee for England Chair Dr Kate Bramall calling it ‘an act of desperation’.
 
‘For too long, we’ve been unable to provide the care we want to,’ she said.
 
‘We are witnessing general practice being broken.
 
‘The era of the family doctor has been wiped out by recent consecutive governments and our patients are suffering as a result.’
 
The action has left RACGP President Dr Nicole Higgins more concerned than ever that Australia could be heading down the same road, saying the action ‘serves as a warning to our Government’.
 
‘This is what happens if we fail to invest and recognise the contribution that general practice makes to our healthcare system,’ she told newsGP.
 
‘Australian GPs are watching the UK closely to see how this unfolds.’
 
The move against the NHS, which began on 1 August after a ballot showed 98.3% of voters in favour, is not a strike and GPs will not be closing their doors.
 
Instead, the BMA has put forward 10 measures GPs can take, and practices can choose which ones they apply.
 
Options include choosing to not perform work they are not formally contracted for, not sharing patient data unless it is in their best interest, or referring patients directly to specialist care rather than following more complex NHS processes.
 
Other options include switching off NHS software which tries to cut prescribing costs and limiting the number of patients seen in a day to 25.
 
The RACGP has been warning of the dire consequences Australia faces if it falls into line with the NHS, highlighted by the fact that UK-trained GPs are leaving their home countries in droves to escape the system.
 
Last month, the UK announced that money will be shifted from hospitals into general practice in a bid to improve access to family doctors following decades of underfunding, in a move the RACGP described as a ‘big red flag’ for Australia.
 
Recent UK reports also laid bare the consequences of lesser-trained UK health professionals missing life-threatening diagnoses, as well as a lack of primary care investment.
 
It is the first time in 60 years UK GPs have staged industrial action, which Dr Higgins says ‘demonstrates the degree of distress they have been under for a long time’.
 
‘General practice has been devalued, defunded, and the role of GPs has been further devalued through role substitution and a lack of respect and recognition,’ she said.
 
Dr Bramall said the UK Government has been given ‘countless opportunities to address the funding crisis in general practice’.
 
‘Still nothing was done,’ she said.
 
‘Practices are now struggling to keep the lights on, can’t afford to hire much-needed GPs and other staff, and some have even closed for good’.
 
The NHS issued a statement asking the public to ‘still come forward as usual for care during collective action by GP services’.
 
‘It is vital that patients still attend their appointments unless they are told otherwise, and practices should inform you of any changes to services,’ it states.
 
‘NHS teams have worked hard to plan for disruption and to mitigate this where possible to ensure services continued to be provided for patients.’
 
To avoid sliding down the same path, Dr Higgins says the Australian Government must now make a commitment to dedicate 10% of the health budget to general practice.

‘If we fail to invest in general practice, we may end up down the UK pathway.’
 
There is no end in sight for the action, with the BMA stating that ‘because GPs will be following their working contracts only, this means that collective action can carry on indefinitely if necessary’.
 
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Dr Christopher Jakob Topovsek   10/08/2024 8:01:03 AM

It would appear, in Australia at least, that “the era of the family doctor” commenced its decline the day Medicare was introduced.


Dr Tuan Quoc Lieng   10/08/2024 8:06:57 AM

Perhaps Dr Higgins and RACGP should consider similar action instead of adopting further watch and wait?


Dr John Anthony Crimmins   10/08/2024 9:02:34 AM

In Australia a large group of Rural GPs -including myself-successfully used industrial action in the 1887 Rural Doctors dispute under the leadership of Dr Paul Mara. The resulkt was a dramatic recognition of thge rural GP with incresaed state health funding especiall for remote rural GPs such as me. It kept me rural for 8 yaers rather than take a more lucrative alternative in Sydney.
How about the RACGP have a chat with a Union to see how it is done by experts.


Dr Petronella Barbara Slootmans   10/08/2024 12:20:21 PM

Ironically this morning after reading about pharmacists’ extended scope of prescribing medications, I thought we need industrial action now to prevent further decline in GP.


A.Prof Christopher David Hogan   10/08/2024 1:39:29 PM

UK GPs are fiercely united by a common enemy . United collective action is a profession's most powerful industrial weapon against severe inequity & injustice.
Recently Australian General Practitioners are starting to communicate better with each other thru the various social media networks.
They are utilising their official representative groups more but do not seem to appreciate that any representative group is only powerful if they are supported by their members.
Leaders & advocates can say what they like but if they only have excellent logical arguments & overwhelming evidence nothing happens. This is politics not a debating class.
Advocacy only really happens when grass root GPs communicate with with their local politicians & back up their leaders in their own words- by any or all of letter, email, social media , phone call & visits.
Only then do they know we are serious.
BTW we see roughly 80% of the population annually - inform them as they vote.


Dr Jim Aroney   10/08/2024 2:07:21 PM

To have 10% of health funding going to GPs is good but it needs to be distributed fairly amongst all GPs ie a general increase in rebates for consultations, not just go to the well connected through complicated incentive payments.


Dr Cherry M. Evans   10/08/2024 3:38:14 PM

The ploy of getting patients here to register with their G P is just a step towards copying the U K system where patients can only attend the practice where they are registered and it is difficult to change when you move location. Also, per capital billing disadvantages doctors seeing complex consultations.


Dr Cherry M. Evans   10/08/2024 3:40:52 PM

With regard to medical testing of G Ps over 70 years of age.How many GPs are there in Australia and how many of them are over 70.


Dr Abdul Ahad Khan   10/08/2024 3:55:22 PM

Dr. Higgins, what is stopping you from organising over here, a Similar Industrial Action RIGHT NOW - what exactly are you waiting for ???
Dr. Ahad Khan


Dr Joanna Holland   12/08/2024 2:00:15 PM

Prior to the introduction of Australia's national health insurance scheme, they did their due diligence and commissioned a study of nationally funded health care schemes around the world. The report emphasised that while politically popular, and good for health outcomes at an individual level, such systems proved extremely costly and difficult to remove. The government is a health insurer, where premiums are compulsory Medicare levies. All insurers aim to limit costs while still selling themselves as essential good guys. They will lump you with 'over-servicers', and pressure frontline providers (GPs and hospital doctors) to reduce costs while maintaining best practice. Don't expect good press or recognition for your work: as far as the political bean counters are concerned - you are an expense, a liability, a source of increasing deficit. Only you, your colleagues and your patients know the true value of your care. Charge as you believe appropriate to your level of service.


Dr Abdul Ahad Khan   14/08/2024 4:59:08 PM

All GPs in Australia combined, constitute < 1% of the population.
Hence, all Political Parties care a Damn about the Cries of GPs ( < 1% of Votes )

But, all Political Parties will be all Ears, when the other > 99% of the Populace raise a CRY.

A rolling ' Stethoscope - down Strike ' each Monday by GPs Nationwide, will start a CRY from the > 99% & will bring the Govt. to a Negotiating Table.
The RACGP / ACRRM / AMA can organise such a Strike & widely use the Newspapers / Radio / TV / Facebook, to explain to the >99% of the Populace as to why their Family Doctor is on a Strike.
DR. AHAD KHAN


Dr Catherine Emma Linda Sloan   17/08/2024 2:56:57 PM

1. In what way are we becoming the NHS?
2. UK GPs are finally deciding to do only what they are contracted to do, after decades of bending to pressure to provide endless best-possible care for every patient, regardless of whether that care falls within the contract. So think now: in what way are you personally providing uncontracted care?