Eight in 10 GPs support industrial action over junior doctor contract

EXCLUSIVE More than 8 in 10 senior GPs support registrars and junior doctors taking industrial action over the proposed imposition of a contract by the Government, a Pulse survey has revealed.

The survey of 866 non-trainee GPs found that 84% said they would support their colleagues in taking action following a ballot, which began today.

Of the 34 GP trainees who have responded so far, 24 said they were going to vote in favour of industrial action.

The ballot – which ends on 18 November – follows an ongoing row between the BMA’s Junior Doctors Committee and the Government, which has threatened to impose a contract on trainees that will see them given far less reward for weekend working and will remove safeguards around safe working hours.

Health secretary Jeremy Hunt stepped in with a last minute offer yesterday aimed at preventing the ballot, which he claimed would seejunior doctors being given an 11% increase to basic pay.

However, the BMA has repeatedly said that it will negotiate with the Government only when Mr Hunt lifts his threat of a contract imposition., while Government claims that only 1% of doctors will receive a pay reduction have been questioned.

Dr Louise Clift, a GP registrar in Gloucestershire, said she would be voting in favour of industrial action, and dismissed claims that the new offer would result in a pay rise,

She said:  ’Jeremy Hunt is completely barking up the wrong tree if he thinks he can pull the wool over our eyes with an ”11% pay rise”. This is nothing more than a pay cut for me and the majority of my junior doctor colleagues.

’If this new contract comes in… I will not be able to afford my mortgage and seriously worry that I will lose my home.’

GPs responding to Pulse’s survey said that excessive workload, unsafe hours and lack of remuneration justifiably called for strike action.

Dr Sally Whale, a GP partner in Ipswich, said she worried about the incentives to go through junior doctor training.

She said: ‘The new contract will have several effects: those currently in training will leave; those entering training will choose the less intense and antisocial rotas; those considering medicine will think again; and Australia, New Zealand and Canada for a start must be rubbing their hands with glee.

‘We need young people to want to be doctors, to enjoy their training, to develop as well rounded individuals who care about society, and feel fulfilled, we will only get that if those currently doing the job feel valued. The NHS has possibly the most demoralised workforce. I have seen it on its knees in the past, but this time I have fears about the underlying intention.’

Emma Humphreys, a GP locum in Waveney, said: ‘What has been expected of juniors was already excessive. Pay hasn’t kept pace with inflation, juniors no longer get subsidised accommodation and the workload is enormous. No other professionals are treated so badly, with such long hours, so much responsibility and remuneration that doesn’t reflect this.’

Dr Chaand Nagpaul, GPC chair, said: ’Junior doctors form the backbone of the NHS, and have our full support in their struggle to get a fair contract that’s safe for patients.

’The current proposals will remove vital protections on safe working patterns, devalue evening and weekend work, and could have a real impact on the quality of patient care.

’The BMA has been clear throughout this process that we want to reach a negotiated agreement with the government. Without the reasonable assurances junior doctors require, the BMA has been left with little option but to continue with plans to ballot members on industrial action. This is not a decision that has been taken lightly, but the government’s refusal to work with junior doctors, and its continued threat to impose an unsafe and unfair contract, has left them with no alternative.’

Announcing the new offer yesterday, Mr Hunt said: ’Our proposals offer better basic pay with increases based on responsibility instead of time served, a shorter working week and improved patient safety. I appeal to the BMA to do the right thing and come back to the table to negotiate for its members.’

The row brought some 20,000 people marching through the streets of London in protest last month.

Survey results in full
[Non-trainees] Would you support junior doctors, including GP trainees, taking the industrial action proposed by the BMA over the junior doctor contract?
Yes: 84% (725)
No: 9% (77)
Don’t know: 7% (64)
Total: 866

[GP trainees only] Are you going to vote in favour of the industrial action proposed by the BMA over the junior doctor contract?
Yes: 71% (24)
No:26% (9)
Don’t know: 3% (1)

Case study: ‘This will disproportionately affect GPs unless we get safeguards’ – Pulse

The new junior doctor contract will disproportionately affect GP trainees unless we get safeguards. The numbers of people wanting to go into GP training have plummeted, in part due to the bad treatment, publicity-wise, of GPs. GPs are the backbone of the NHS but no single part of the NHS can work without any other part: we rely on hospitals, hospitals rely on us.

I never signed up to be a GP with the expectation that things would always stay the same, because medicine innovates and moves on, but I am concerned that it’s changing for the worse. Patients could be left really vulnerable because of massive understaffing or staffing by locums, which doesn’t give continuity of care.

While I agree with making the NHS as efficient as it can be so we get the maximum for patients for the minimum cost, there’s a point when cutting costs crosses over into being dangerous.

GPs have a choice to work abroad and have better working conditions; I feel angry because there seems to be a lack of appreciation and understanding of the stress and the challenges we face.

Interestingly, with the press covering the protests, I’ve received unprompted comments from patients and neighbours about how much they really appreciate what we do.

Without swearing, my message to Jeremy Hunt would be: take a really hard look to understand the nitty gritty of our day-to-day job, and then you’ll see why we’re demonstrating.

Dr Paula Newens is a GP registrar in east Kent 

Originally published by Pulse.

Video: Junior doctor contract protest draws 20,000-strong crowd – Pulse

Some 20,000 doctors and members of the public marched through London on Saturday afternoon to protest against the Government’s proposed junior doctor contract changes.

Doctors, lawyers and political leaders gave speeches in support of junior doctors, including shadow health Secretary Heidi Alexander, 92-year-old NHS activist Harry Leslie Smith and BMA Junior Doctors Committee chair Dr Johann Malawana.

The proposed changes, which would come into effect next August, would extend junior doctors’ plain time hours, so that instead of normal pay being given for hours worked Monday to Friday 7am to 7pm with hours outside of that paid 20-50% extra, plain time would last until 10pm and include Saturdays.

 It would also scrap the GP trainee supplement and replace it with a ‘pay premium’ recognising it as a shortage specialty.

Marching along Pall Mall and Whitehall, the protesters finally gathered outside Parliament to express their views.

Addressing the health secretary, Dr Malawana said: ’Jeremy Hunt, I have said to you again and again, stop attacking us. What kind of society devalues NHS staff? What kind of society devalues the very staff that deliver frontline services at 2 o’clock in the morning on a Sunday night, and do it because they care about the patients in front of them.’

Ms Alexander said in her speech: ’I’ve come here today, be under no illusion, to send a clear and strong message to David Cameron and Jeremy Hunt, that junior doctors should be paid fairly for the work that they do. I hear you when you say, it might be junior doctor contracts today, but what is it tomorrow?’

Junior doctors also rallied in Belfast over the weekend amid fears that the devolved administration will implement the changes proposed for England.

According to the BMA, propositions do away with contractual safeguards, including a 30-minute break for every four hours worked. Instead, the new contract entitles doctors to one 20-minute break in a shift of up to 11-hours.

The BMA has refused to re-enter negotiations on the contract after a plea from health secretary Jeremy Hunt last week, in which he gave a ‘cast-iron’ guarantee that pay would not fall and suggested he may be open to concessions on Saturday plain time hours.

Mr Hunt had met with Dr Malawana after learning that the BMA isplanning to ballot junior doctors on industrial action.

Junior doctors have until 23 October to update their details with the BMA to ensure they can take part in the ballot.

Speaking to Pulse at Saturday’s protest, BMA GP trainee subcommittee chair Dr Donna Tooth said: ’There are people saying that with the removal of the training supplement, they will no longer be able to afford to train to be a GP.

’There have been some assurances from the government that GP trainees’ pay won’t be affected, however until I see those assurances written down, rock-solid assurances, I can’t reassure my committee and the membership that I represent, that the future of general practice and training is secure and that our salary will be safe.’

Mr Hunt has said he will impose the contract if the BMA does not agree to changes but the Scottish and Welsh Governments have no plans to introduce it. Amid political instability, which included most ministers resigning their posts, the Northern Irish Government has not announced a decision yet.

The marches followed an earlier protest on 28 September, when about 5,000 junior doctors gathered outside Westminster. Doctors also protested on the streets of Manchester during the Conservative Party Conference earlier this month.

Originally published by Pulse.

GP practices to provide advice on job seeking in new pilot scheme

Practices are offering careers advice for the long-term unemployed as part of a scheme which aims to overcome health-related barriers to work.

The ‘Working Better’ scheme in Islington, north London, was launched on 1 September and will see practices offering one-on-one employment coaching.

The scheme, run by Islington Council, Jobcentre Plus and NHS Islington CCG, comes in response to the council’s independent employment commission last year, which called for employment support services to be provided in places where hard-to-help people already went – like GP surgeries.

Costing nearly £90,000, the intensive and personalised employment coaching pilot scheme has been taken up by five surgeries so far.

Dr Josephine Sauvage from the NHS Islington CCG explained that the employment drive aims to redress isolation and confidence issues, which are often associated with long-term health problems.

She said: ‘When we become ill we often stop doing those things that get us out and about and bring fulfilment to our lives. As a local GP I see and hear this every day and I’m very keen to do more to support my patients’ well-being.

‘Prescribing free and confidential employment coaching, delivered in a caring and familiar environment, could be really beneficial to a patient’s confidence and self-esteem, as well as their long-term recovery.”

Cllr Richard Watts, leader of Islington Council, said: ‘Health services are often quite disconnected from employment services and frontline health staff don’t feel comfortable talking about returning to work with their patients. We think there is much more that health services can do to promote the idea of employment for people with health conditions.’

Originally published by Pulse.

TV campaign aims to identify ‘thousands’ with undiagnosed coeliac disease

A TV advert aiming to encourange ‘thousands’ to see their GP about undiagnosed coeliac disease it set to premiere on several channels today.

The advert, which forms part of a wider campaign by the national charity Coeliac UK and is narrated by coeliac disease sufferer and TV acress Caroline Quentin, shows people struggling with some of the most commonly reported symptoms of coeliac disease, such as frequent bouts of diarrhoea, fatigue and stomach pain.

Viewers are encouraged to fill out an online assessment form which, if the person displays any related symptom, has an irritable bowel syndrom (IBS) diagnosis or has a close family member with a coeliac disease diagnosis, prompts them to visit their GP practice for a blood test.

The charity said the campaign, which also aims to target patients via displays in GP waiting rooms, comes as it currently takes an average of 13 years for a patient to receive a diagnosis of the disease which makes sufferers intolerant to gluten.

The odds of developing the disease are one in 100 in the UK, rising to one in 10 for close family members of sufferers. Younger adults and those from lower socioeconomic classes are the least likely to have received a diagnosis for their condition, the charity said.

Coeliac UK chief executive Sarah Sleet said the TV advert, set to air on channels including ITV, Sky1 and Dave, would ‘reach millions of viewers’, and hopefully ‘put thousands suffering with symptoms on a pathway to diagnosis’, avoiding ‘potentially life threatening long term health complications’ as a result.

She said: ‘With half a million people living with undiagnosed coeliac disease we must take radical action to turn around this horrendous situation.’

NICE guidelines on coeliac disease, on which the online assessment is based, are due to be revised in September to help improve management of the disease.

Young women avoid discussing sexual health with GPs because of fear of saying ‘vagina’

Young women are avoiding going to a GP for gynaecological issues because of ‘embarrassment’ and ‘fear of intimate examination’, a new study has revealed.

Instead of seeking help from a doctor, more than half (57%) would turn to Google, with another one in five preferring to confide in their mums.

In a survey of 1000 women, those aged 18-24 were four times less likely to go to a doctor with a sexual health issue than their 55-64 year old counterparts.

Two thirds of young women were embarrassed to say the word ‘vagina’ (66%) or ‘orgasm’ (64%), with over half being embarrassed about ‘labia’ (60%) and ‘discharge’ (56%).

Nearly half avoided going to the doctor because of being scared of being intimately examined (48%) or being embarrassed to talk about sexual health issues (44%). Some 26% didn’t seek professional help because of not knowing what words to use.

The embarrassment factor dropped considerably among older participants, with just one in 10 (11%) aged over 65 saying they would be shy saying ‘vagina’ to a healthcare professional.

Katherine Taylor, acting chief executive at Ovarian Cancer Action who led the study, said: ‘The reluctance to see a doctor for gynaecological issues is really worrying and, while many of us have turned to the internet for help, googling symptoms is not a substitute for proper medical attention.

‘Illnesses such as ovarian cancer – which kills a woman every two hours in the UK – is much easier to treat if it’s diagnosed early, so it’s incredibly important that women feel empowered to talk about their health and feel comfortable visiting healthcare professionals.’

‘It’s so important that women are empowered to discuss these issues. Saying vagina won’t kill you, but avoiding saying it could.’

Originally published by Pulse.

GPs to star in BBC documentary

GPs in the Peak District will be the stars of a new TV show airing this September, after allowing BBC cameras to follow them around for the last year.

The two-part documentary ‘The Real Peak Practice’ promises to shine a light on the everyday struggles of general practice including problems with recruiting new GPs and keeping elderly patients out of hospital.

Focused around the Baslow Health Centre, a rural practice where almost one of three patients is over 65, the show is narrated by TV actor Dominic West, especially known for starring in US TV drama The Wire but also a native of the nearby village of Grindleford.

The documentary follows GP partner Dr Louise Jordan in her work at the practice as well as for local end-of-life care charity the St Helen’s Trust, where she is a trustee.

The BBC’s executive producer on the show, Sally Bowman, said its production had been ‘a humbling experience’.

She said: ‘The team at Baslow Health Centre are so dedicated to their patients and determined to do their best in sometimes very difficult circumstances.

‘We know that 90% of patient contacts with the NHS are through their family doctor but television tends to concentrate on the dramas of A&E. Over the past year I’ve learnt that there is just as much drama behind the scenes of primary care and just as many unsung heroes too.’

The show follows rival Channel 5’s series ‘GPs: Behind Closed Doors’ which aired last year.

Originally published by Pulse.

Bin practice boundaries altogether, says think-tank

GP practice boundaries should be disposed of completely and patients allowed to register with any CCG in the country, accessing all primary care providers within that region, according to a new report by the Institute of Economic Affairs think-tank.

The report published today, ‘A Patient Approach: Putting the consumer at the heart of UK healthcare’ discussion paper, calls for an NHS overhaul to allow CCGs to privatise, specialise and ‘compete’ for patients, through merging and demerging with other CCGs.

As a result, patients should be able to ‘choose freely among primary care providers, it says.

The Government has already introduced its ‘patient choice’ scheme, which allows practices to open up their boundaries and take on patients from out of areas.

As previously reported by Pulse, only 10,000 patients have registered with a GP away from their home since practice boundaries were abolished in October 2014, despite original claims from the Department of Health that up to 6% of patients were keen on moving to practices closer to their work.

But the IEA says that the Government should go further, and allow all patients to choose practices across the country, without practices opting in to the scheme.

The report says: ‘The whole concept of “catchment areas” should be abolished. Patients should be able to register directly with any CCG they see fit, and choose freely among primary care providers. Meanwhile, CCGs should be able to operate nationally, and to merge and de-merge with other CCGs, as well as provider organisations. CCGs would effectively become social health insurers, and the sector should be opened to private insurers as well.’

The think-tank also said it was ‘very much an open question’ whether GPs are the best people to lead CCGs.

Instead, it recommends an ‘internal market’ in which ‘optimal size and scope’ of the CCGs would be discovered through a competitive process.

The report adds that this approach ‘would mean the end of political reorganisations, and the beginning of reorganisation by the market’.

Originally published by Pulse.

Practices to take on minor injuries work as plans for specialist unit are shelved

GPs in South Gloucestershire are likely to deal with minor injuries including minor fractures, minor burns and scalds as part of a pilot scheme, after the health secretary vetoed plans for a minor injury unit in a local hospital.

NHS South Gloucestershire CCG said that, under its proposals, ‘additional staffing and resources will be put in place to provide the necessary extra capacity’ so minor injuries services could be delivered by practice-based nurses supported by GPs.

It comes after Jeremy Hunt decided in June that a proposed unit at the Cossham Hospital would not be built, despite 18,000 residents signing a petition in favour of it, and 250 people demonstrating at the council offices in Kingswood.

The CCG announced the plans this week, which would see practices treating injuries including sprains and strains, cuts and grazes, minor fractures, minor burns and scalds, bites, minor eye injuries and minor head injuries.

It would not treat those needing plastering or crutches, or experiencing severe breathlessness, severe abdominal paint, severe chest pain or strokes.

The services would be available within normal GP opening hours, from 8.30am to 6.30pm Monday to Friday, though the CCG is considering extending the service to outside of these hours.

NHS South Gloucestershire CCG will make a formal decision on whether to proceed with the pilot in September.

Dr Ann Sephton, deputy clinical chair and lead for emergency and urgent care at NHS South Gloucestershire CCG, said: ‘People have told us they want better access to their GP practices and better access to urgent care services in the community. This new service aims to deliver both – through a GP practice-based model delivered at surgeries throughout South Gloucestershire.

‘We believe our proposal is the best and most cost-effective option for improving local access to minor injury services in South Gloucestershire.’

Originally published by Pulse.

Petition for Hunt’s removal as health secretary surpasses 100,000 signatures

Over 100,000 people have signed a petition calling for a vote of no confidence in health secretary Jeremy Hunt in just 24 hours.

The petition launched via Parliament.uk, started yesterday and quickly surpassed the 10,000 signature target at which the Government must issue a response. This afternoon it has reached the 100,000 required to be considered for debate in Parliament, having attracted more than one signature per second.

Launched by north London-based consultant in internal medicine Dr Ash Sadighi, it accuses Mr Hunt of ‘alienating the entire workforce of the NHS by threatening to impose a harsh contract and conditions on first consultants and soon the rest of the NHS staff’.

A separate petition launched via Change.org on Sunday calling on Mr Hunt to resign, or Prime Minister David Cameron to remove him from his post, has received over 90,000 signatures.

Both petitions were launched by consultants angered by Mr Hunt’s speech at the King’s Fund last week, in which he threatened to impose his terms for the new junior doctor contract and accused the BMA for being out of touch with its members, claiming he had ‘yet to meet’ a doctor not in favour of weekend working.

They follow the success of the #ImInWorkJeremy Twitter campaign to trend over the weekend, uniting GPs and hospital doctors in letting Mr Hunt know they were already keeping a seven-day NHS running.

Meanwhile, geriatric consultant Dr Dan Furmedge, who launched the Change.org petition, also said Mr Hunt’s speech had been ‘the last straw’.

His petition read: ‘In essentially calling doctors lazy and suggesting they need “a sense of vocation” he has offended the whole NHS workforce and demonstrated how little regard he has for us and how little he understands what we do.’

Originally published by Pulse.