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Majority of UK's GPs would consider resigning

From the BMA

1 June 2001. More than half the family doctors in the UK will consider resigning from their NHS contracts next spring if the BMA's General Practitioners Committee (GPC) is not able to secure new and acceptable contracts and negotiating rights for all GPs.

In a ballot of all 36 000 GPs in the UK, the BMA asked family doctors to answer yes or no to the question: "Would you be prepared in April 2002 to consider submitting an undated resignation from your present NHS contract should the Government fail to agree to both significant and acceptable changes to the present General Medical Services (GMS) contract and the right of the GPC to negotiate on behalf of all NHS family doctors?"

The overall UK-wide response rate to the ballot was 66% with 22 380 GPs sending back their ballot forms. Of these family doctors, more than eight out of every 10 GPs (86%) voted yes — they would consider resigning next April if a satisfactory outcome is not reached by then.

Similar high response rates and overwhelming 'yes' votes were returned in all four countries of the UK.

• in Scotland the response rate was 69% with 84% of those doctors voting 'yes';
• in England the response rate was 65% with 86% of those GPs voting 'yes'; and
• in Wales the response rate was 63% with 87% of the GPs voting 'yes' and in Northern Ireland with a response rate of 67%, a massive 90% of family doctors voted 'yes'.

Dr Hamish Meldrum, joint Deputy Chairman of the BMA's General Practitioners Committee said: "The message this ballot sends could not be clearer or louder. The result demonstrates the depth of disenchantment, despair and disillusion felt by GPs throughout the UK.

"Regrettably, they dramatically confirm what we have been telling governments for years, that general practice is at the end of its tether.

"For our part, the GPC is pledged to work with the incoming government to achieve a solution to these problems — a solution that provides our patients with the quality of care they have a right to expect, delivered by a sufficient number of enthusiastic, well trained, valued professionals.

"It will not be easy, but I call upon the incoming government to work speedily and constructively with us to achieve that goal. I am sure the public will expect no less."

Non-principal GPs who do not hold an NHS contract but work in general practice in a variety of ways such as locum GPs, were asked if they supported their principal colleagues. A resounding 92% of non-principal respondents voted 'yes'.

The decision to ballot all GPs was taken before the announcement of a general election and ballot papers were sent out before the general election date had been set. The BMA's decision to publish at this time was based on making the results public at the earliest possible opportunity. The current crisis in general practice results from under-resourcing by successive governments and a refusal by those governments to admit that a real and urgent problem exists.

Many of the problems in general practice stem from having too few doctors faced with an ever increasing workload. The BMA believes the NHS Plan in England alone requires an extra 10 000 GPs to implement it, yet the Government promised only 2000 extra GPs over a four-year period. Even this modest growth seems unlikely to occur: a headcount of new GPs for 1999/2000 showed an increase of only 113 and many of those would not be working full time. In the previous year, 1998/99, when the headcount of extra GPs was 199, taking into account the fact that more GPs are going part-time, by the end of that year this resulted in only 20 additional whole-time equivalent GPs.

Dr Meldrum said: "Morale among GPs has never been lower, workload and expectation never higher. There has been a persistent failure to provide the level of resources at practice level to enable family doctors to treat their patients properly or quickly. GPs want more time with their patients, time to provide a first class service. Now it is the incoming government's turn to provide time for general practice."