Independent #BMA representation a step closer

The BMA’s GPC Sessional GP Subcommittee has pulled off a major coup by getting its plan to change the way Sessional GPs are represented on the GPC past its first hurdle by having it accepted by the GPC – completely unscathed! Currently, Sessional GPs are under-represented and so our employers are making political decisions for us, despite the obvious conflict of interest in employers representing their own employees. These changes however, if all goes well, could mean, for the first time in the BMA’s history, that salaried and locum GPs have at least some autonomy within the BMA. Not quite independent representation, but it’s a leap in the right direction.

Because of the scale of some of the plan’s proposed changes, it still has to go through a series of committees, from the GPC’s Financial Committee, BMA committee, the conference of LMCs in June and the BMA Annual Representatives Meeting.

Assuming all of that goes as intended – and there certainly seems to be a palpable appetite for a change in the way Sessional GPs are represented on the GPC from all sides – we can expect to see some significant changes.

The most fundamental change will be that the Sessional GP subcommittee, for the first time, will have ‘formal delegated authority to act on matters that relate wholly or primarily to sessional GPs’. In a word, autonomy from the rest of the committee, representing a sea-change from the current system where all business involving changes to Sessional GPs has to be passed via the main committee.

In order to discharge its new powers, the GPC has also agreed to double the size of its committee to 16 members, to increase the number of meetings to 4 a year and to appoint its own executive committee. Members of the sub-committee will continue to be elected from across the UK, with new provision to ensure that representatives are elected from 12 geographical regions and that the subcommittee contains both salaried and freelance GPs.

What some may see as contentious is that only 4 spaces will be guaranteed for Sessional GPs on the main GPC committee (the spaces which exist at present). However, the current situation is that the GPC only co-opts 4 sessional GPs on an informal basis, so the new arrangement will cast this in stone. Additionally, there is absolutely nothing to stop any Sessional GPs who wish from applying for the elections, held every year, for one third of the regional seats on the GPC.

On the assumption that this is all going to pass successfully by all the necessary political processes of the BMA, perhaps the only potential fly in the ointment remains in what actually happens outside the GPC – namely, us sessional GPs. After years of emasculation and disenfranchisement, and an underlying collective cultural sense of not being ‘proper GPs’, Sessional GPs need to realise what a positive career choice working as a locum or salaried GP can be, and what a vital role we play in delivering primary care. One really proactive step, therefore, that each of us can take is to contact our Local Medical Committee. I’m not suggesting that you serve on its committee, simply to register your support and ask them what they can do for you. Although many of us may perceive LMCs as a bunch of stuffy old grey fuddy-duddys in their current form, they actually serve a statutory role directly between the individual GP and the GPC and are simply the embodiment of our own local demographic. LMCs are, very much, simply what we want them to be and, for us as GPs (assuming the Sessional GP Sub-committee manages to get its plan passed through all the relevant committees) it will become increasingly hard not to blame ourselves for their potential shortcomings. A great first step would be for you to lobby your LMC to support the GPC’s paper on its way through all these various committees.

The NASGP is relieved that the GPC has begun this process of emancipating its representation of Sessional GPs, but also realises that it’s not yet all in the bag. The BMA still has bridges to mend when it comes to the representation of salaried GPs in practice disputes; many Sessional GPs will need a lot of persuading that the BMA/GPC have their best interests in mind and are still capable on delivering this new Plan; and a huge amount still needs to be done to reverse the learned helplessness that so many Sessional GPs experience. Not that any of that should stop us Sessional GPs being open to the new GPC plan, and we all look forward to the hope of change that the full adoption of this plan could signify.

Londonwide LMCs surveying Sessional GPs

Londonwide Local Medical Committees are reviewing their representation of GPs in London. We’ve been asked to disseminate the survey to as many salaried and locum GPs who work in the London area as possible, and you can access this survey here – and there’s even a chance to win £25 of Amazon giftvouchers. Closing date is Friday 29 January 2010.

NASGP in talks with alternative trade union to BMA

Pulse are to run a story about NASGP having talks with another trade union (MPU-Unite) other than the BMA about representing salaried/sessional GPs.

It’s still early days, but after I accepted an invitation to fill the MPUs vacant seat on the General Practitioners Committee as an individual member of MPU, the BMA discussed NASGP’s private talks with the MPU in an open session. So word has escaped to Pulse who of course are eager to publish this news now.

So why the MPU?

There comes a point when one has heard too many salaried GPs sobbing down the phone. Bullied by their employers, as employees they have turned to their trade union only to find that that same union also represents their employer – hardly surprising when the BMA go round saying they’re the ‘only’ trade union for GPs.

It’s not that the BMA have maliciously set out to mislead GPs. The BMA is a huge organisation and clearly does fantastic work for our profession. It is the only doctors’ union with negotiating rights with the government (MPU gave away their rights to the BMA in the sixties – hence the position on the GPC) and offers a host of other products and services for the profession.

But our profession has changed massively and irrevocably over the last 20 years. Then, locum GPs were just a minor inconvenience and salaried GPs barely existed; BMA members were overwhelmingly either employed hospital doctors or GP Principals. Now only 60% of GPs are principals – the rest are us salaried GPs and locums. The BMA is the only trade union in the democratic world who say they can represent employers and employees, which is as ridiculous as saying that the secret to human flight is to fall to the ground and miss – it’s just not possible, no matter who good the intention. As unnatural as defying gravity.

A working party of 7 NASGP members has considered several options presented to it by the MPU. Our plan for now is to start by working with the MPU to increase our members awareness of the MPU as a trade union that can help out vulnerable salaried GPs when it comes to independent representation in a practice dispute, plus other benefits that such a large organisation can offer. And, in addition, we’re looking at ways that the MPU can work with the NASGP to further benefit Sessional GPs – but all early days and certainly no details on this to report yet as talks on this are only just beginning! What we can certainly say now is that membership of the MPU together with the BMA is in no way mutually exclusive.

Over the coming months we will be working hard with the MPU to increase awareness of how Sessional GPs can benefit from greater representation and will, as always, keep our members informed of progress here on the blog and our MPU section of the NASGP website.

The salaried/partner divide

NASGP member John Pike puts forward the case for a seperate trade union for Sessional GPs.

Most salaried doctors believe a damaging split has opened up between them and GP partners, a “GP” newspaper survey reveals.

It is clear that the profession is deeply divided and a divided house will fall. There has been much talk in recent years of tackling this most serious issue, but little if anything has changed.

A few weeks ago, a “GP” survey showed that, on average, salaried GP pay was just over 50% that of PMS partners.

Despite tht greater burden of management that Partners must bear, I do not think that can justify such a huge differential and, in addition to the issue of pay, I have seen anecdotal evidence to suggest that some Partners do not always treat their salaried colleagues fairly in other ways (eg contractual).

As has been highlighted on the NASGP blog recently, it is impossible for the BMA to represent both Partners and Sessional GPs when their interests are so different and, indeed, opposing in some aspects. What is needed is a new union, specifically for Sessional GPs, without a conflict of interest issue, and to address matters of pay and contracts without further procrastination.

BMA letting salaried GPs down

Salaried GPs really need to see both sides of the BMA coin. On the one hand, the BMA, through its General Practitioner’s Committee (GPC), has an active Sessional GP Subcommittee; produces an excellent Salaried GP Handbook; has a veritable army of industrial relations officers and has the fair representation of salaried GPs enshrined as part of its core business.

But this wonderful altruism towards salaried GPs lacks one very basic yet fundamental law: an organisation designed to represent employers can not possibly ever do the same for its members’ employees. I’ve yet to come across any other trade union in the democratic world that makes the same claim as the BMA.

The BMA is the doctors union, predominantly representing employed hospital doctors and, through its craft committee the GPC, GPs. These GPs, however, are mostly contractors and not employees – only 17% of GPs are, strictly speaking, employees. 25% are locum GPs and the remaining 60% are PMS/GMS contractors.

It’s a representational mess and the BMA is just tying us in knots. And its salaried GPs who are being strangled.

Here at the NASGP we get email after email from bullied, neglected and abused salaried GPs, often too scared to make a fuss as, not only do they know that ‘making a fuss’ will be followed by them being ostracised for being an employee at another practice, they will be unable to get impartial help from their trade union that also represents even more GPs on the other side of their employment contract.

So the BMA needs to make a choice and let go of its hold on the representation of either its employers or employees. Although it has been looking after PMS/GMS contractors the longest, I actually think it’s this lot, already well organised and empowered, who would be the best group to be jettisoned from the BMA, leaving Sessional GPs under the protection of the BMA, particularly as the BMA already looks after many more employed doctors in secondary care.

If they don’t make up their mind, or whilst they’re trying to decide what to do, Sessional GPs need to consider an alternative to the BMA-GPC-LMC trade union axis and join an independent trade union. I’m not saying that Sessional GPs need to necessarily resign from the BMA – the BMA offers services above and beyond a trade union – but we need to belong to a trade union independent from our employers.