The meeting with the GMSC took place at BMA House on Thursday 4 June
1998.
In presence were Drs Abrol, Bell, Chand, Meadows, Risk and
Trenchard. GMSC was represented by Drs Chisholm (Chair of GMSC),
Fradd and Gillys (?sp)(Co-Chair of GMSC) as well as the BMA Director of
Primary Care.
Meeting started with the GMSC being clearly nervous and appeared very
sensitive and defensive about charges of ineffectual leadership and the
apparent about turn. They insisted that they opposed PCGs right from
the start (!). I urged that that was in the past and that we take it
at face value in order to move on to the future and their intentions
regarding the crisis facing general practice.
GMSC agreed with us that the proposals pose a very real threat to GPs
and health care in general. "I believe PCGs are flawed", said John
Chisholm.
He also said that he believed that PCGs threatened patient care,
clinical freedom, general practice infrastructure and independence.
He was particularly concerned about inherited debts, legal
liabilities, TUPE implications, risks of divisiveness amongst doctors
and the lack of preparatory and ongoing support funding.
Dr Chisholm was clearly worried about funding running out on PCGs
'in-year' and the rationing role that doctors will have to undertake.
Chisholm added: "there may come a time when GPs walk away from
arrangements if they do not receive the assurances they seek".
An interesting remark made by Dr Gillys was that they (GMSC) felt that
they were now in "a proper negotiating position". That remark made me
wonder what was the position before?
The bottom line:
I said that my assessment and intuition tell me that the Minister of
Health will concede on 5 out of the 7 requests for assurance presented
to him by the negotiators. This concession, I suspect, was always
intended to be granted anyway if the going got tough.
I added that the 2 demands that the government will find impossible to
give way on were unified budgets and GP majority on governing bodies of
PCGs.
The GMSC negotiators agreed with me.
If that were to happen, and we shall find out at the high noon meeting
on 11 June between GMSC and Milburn, the negotiators confirmed that
they will then seek grassroots opinion in a national ballot. This will
probably come out of the LMC conference on 28 June.
Armed with the results of that ballot (which they believe will be
strongly against PCGs), they would return to the negotiating table.
If the government remains intransigent, the GMSC will then ballot GPS
on possible action yet to be determined.
I am satisfied that the GMSC is beginning to act in the interest of the
profession.
However, I still believe that we need to separate professional from
political representation. That much was very clear when the GMSC
negotiators at the meeting considerably distanced themselves from the
remarks made by Maccara, BMA Chairman of Council, who was very warm
to the WP when it first came out.
I remain committed to not taking any prisoners. The planning for the
British Family Doctors Association continues.
Ahmad
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Dr Ahmad Risk
http://mednetics.org
home: +44 1273 724866
work: +44 1737 240022
fax: +44 1737 244660
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