Tuesday, August 14, 2012

GPC report July 2012

GPC Report
For East and West Sussex LMCs
Dr Russell Brown
20 July 2012
The first meeting of this session of GPC took place, unusually, in Edinburgh, due to the Olympics dominating hotels and BMA House this month.  The city is lovely to visit, though I didn’t get to see much of it due to a pre-meeting meeting of the Commissioning and Services Development Sub-committee.  Although if I’m honest, that last was my own fault, as it was I who suggested meeting beforehand rather than after, as I had a plane to catch.
The first thing to report is the election of the GPC negotiating team: five candidates stood for four positions.  As has been widely reported in the medical comics, those elected were Richard Vautrey, Peter Holden, Chaand Nagpaul and Dean Marshal.  Beth McCarron-Nash was not.  This caused some consternation amongst some of those attending the meeting.  I suspect the result is at least in part down to the vagaries of the single transferrable vote system used.  However, the end result is that the negotiating team is perhaps less demographically representative than GPC as a whole, which is less demographically representative than the profession as a whole.  Richard Vautrey was also made Deputy Chair.
After the elections were held, discussion moved to the progress of negotiations with NHS Employers .  Unfortunately much that was discussed is confidential and I am under threat of death by suffocation if I reveal any details of the debate.  Nevertheless, I am prepared to tell you that the proposed changes to LES arrangements are at the very pinnacle of the mountain of issues the negotiating team intend to address.  There are numerous issues around this which we can discuss in committee if you wish.  Additionally, Julius has already written to colleagues about the contractual status of CCG constitutions, or rather their lack, and a physical signing may not be necessary, nor may 100% uptake.  However, much is uncertain as there are currently no regulations or guidance to assist anyone.  The Health and Social Care Bill (HSCB) of course mandates in clause 28 that all practices in England must be a member of a CCG from April 2013.  With regard to NHS 111, problems continue to be raised with the project board and the official report on the pilots will apparently be published later this month.
We had an opportunity to be addressed by our new Chairman of Council, Dr Mark Porter, an anaesthetist, though this should not be held against him. As you may be able to imagine, his main topic was that of pensions and industrial action.  I am sure you are aware that BMA Council decided, narrowly, to not pursue further industrial action.  He made several points about this, most of which has already been reported in the press but which can be summarised briefly as:
  • No other unions will be taking further action and Labour will apparently not be opposing the Public Sector Pensions Bill;
  • The only escalation which could be reasonably planned would be a full strike and it is unlikely the majority of members would engage with that;
  • The DH and in particular the Treasury are determined not to make any concessions.  However, we took IA to get them to talk to us.  We have now been offered the chance to be involved in the review of the impacts the changes may have, the “Working longer” Review, and other Trades Unions are keen to have us there.   So we are talking.  Just not negotiating.  We could not be a member of that group if we were to take further IA. Being part of it allows at least the potential for influence and mitigation.
Dr Porter made the point that this is not the end.  There will be a campaign to make it clear to all what our position is.  It is perhaps arguable that we should have done that already.  However, regardless of how one feels about the IA taken already, a further escalation is likely to divide the profession and perhaps damage both the profession and our Trade Union permanently.  Having said that, it was obvious, reading between the lines, that there are many differing view points, both on and off Council.  But I probably didn’t need to tell you that.
There was some discussion about how to deal with Premises issues especially how to achieve improvement in funding arrangements.  I note this to advise that this is the case, but this is one of the issues I may not currently discuss in detail.  I can report that the Northern Ireland model is of considerable interest.
Revalidation was discussed again.  There are still many issues unresolved, especially how remediation is to be funded and how certain groups of colleagues such as freelance locums will be able to engage with the process.  However, I am not certain that much will be resolved before the Secretary of State for Health signs the process off as ready and fit for purpose.  The situation on the ground does not seem to be the same as that which is being discussed in the meetings reported to us at GPC.  No doubt it will all come out in the wash.  I just hope the rinse cycle doesn’t damage any of us in the process.
Finally there was further discussion about the non-Commissioning bits of the HSCB.  There is actually little to report.  A summary of most of it could be “meetings are continuing”.  There are some IT developments, in that the DH hopes, by 2015, to have achieved four things, that patients will be able to book GP appointments and request repeat prescriptions, which is achievable, given that many practices already offer this; access to patient records may not be as it is fraught with governance difficulties; e-consultations will for most patients not be their main method of communication with their GP I suspect, but it appears the focus groups the DH uses think it is a good idea.   Who knows, for some, patients and doctors, it may even be workable and secure.
I hope this report is useful.  Given it is my first, any feedback offered will be considered carefully.

Dr Russell Brown
GPC and Chair East Sussex LMC