Could a national association of CMLs upset the direction of general practitioners?

CML representatives gathered in York on 10 and 11 May will participate in a thematic discussion on the formation of a national association of CMLs.

The conference agenda says a “lack of clarity” remains around the issue – and that the debate will seek input from CML representatives on what a national CML association is, how it would work and what its mission might be, what alternatives might exist and how widely supported the idea can be.

While it may be unclear at this stage how the association might work, it is clear that dissatisfaction with GP leadership is the key factor driving the plans.

Direction of the general practitioner

A series of motions submitted by the LMCs described in the agenda as ‘best covered by this thematic debate’ strongly criticize the BMA’s GP committee and its representation of the profession.

The motions show that the LMCs – which represent grassroots GPs across the country – are seriously considering removing funding and negotiating control of GP contracts from the BMA’s GP committee.

The motions suggest discontent runs across a wide spectrum of the profession – reflecting concerns that partners and the independent contractor model are not adequately represented; and that at the same time the BMA is ‘irreversibly in conflict’ and cannot ‘adequately support sessional and contract GPs within one organisation’.

A motion from North Staffordshire LMC states that ‘the current form of national GP representation requires review’ and calls for a review of the ‘GPC record in representing the GP partnership model in annual negotiations’.

Partnership model

A motion from Avon LMC says the GP committee ‘does not serve the GP partnership model’ and demands a ‘separate union’ developed through the LMCs to represent GP partners.

A motion from West Sussex LMC says the BMA GP committee ‘does not demonstrate that it is a functional representative body of GPs’.

More than one motion calls for the BMA GP committee to either be stripped of funding from the LMCs via the levy paid to the GP Defense Fund (GPDF), or that this funding be reviewed.

A motion put forward by Cambridgeshire LMC, meanwhile, suggests that a review by former BMA chairman Dr Hamish Meldrum which led to changes in the way the association operates ‘directly led to a decline effectiveness of some GPC committees and has directly led to changes in the BMA/GPC relationship that further jeopardize the future of general practice”.

GMS contract

It also asks the GPDF to investigate “what other avenues exist to negotiate future national contracts outside of the BMA”.

The debate marks the latest challenge for the management of the BMA GP after high profile criticism over the past year and following contract changes imposed for 2022/23 by NHS England.

GPonline reported this month on a draft letter from the LMCs to the GP committee which called for stronger action to stop the ‘slow death’ of the entrepreneur’s GP model.

The BMA GP committee faced the resignation of two high-ranking figures from political roles last year after resuming talks with NHS England following a vote of no confidence in the services leadership healthcare following comments regarding face-to-face appointments.

The committee faced further criticism after NHS England imposed contract changes which the BMA said could pose a risk to patient and staff safety – and were quizzed over their decision not to go through to a formal ballot on industrial action after an indicative poll showed more than half of cabinets would be prepared to withdraw from NCPs.

The groundwork has been laid for the creation of a national association of LMCs – with a society of the same name set up last year by GPDF leaders following a debate at the UK’s LMC conference of the year last.

In comments to GPonline earlier this month, BMA GP committee vice-chairman Dr Kieran Sharrock called on the profession to “pull itself together” at a time when a declining workforce is facing a workload without previous.

He said the GP committee was committed to the independent contractor model, adding: ‘The profession can be assured that GPC England provides the strongest possible support for the independent contractor model as a cornerstone of medicine general. The voices of grassroots generalists will be instrumental in shaping how we move forward.

Andrew B. Reiter