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GP surgeries face closure over doctor contract delay

By Lisa Smyth

GP surgeries across Northern Ireland have warned that they may be forced to shut their doors to patients in a matter of weeks as the Health Minister delays signing a new contract for family doctors.

One of the most basic NHS services is under threat until Michael McGimpsey agrees to new terms and conditions for GPs, a leading doctors’ union has warned.

The British Medical Association (BMA) has called on Mr McGimpsey to sign the new General Medical Services (GMS) contract — which has already been agreed in England, Scotland and Wales — and will come into force on April 1.

The minister has blamed uncertainty over his budget for his failure to sign up to the new deal, negotiated on a UK-wide basis by BMA representatives and the NHS Employers Organisation — which acts on behalf of the four UK Health Ministers.

A number of changes have been made to the contract, including a pay freeze for GPs, efficiency savings of 4% and a small pay rise for practice staff who earn less than £21,000.

However, these changes cannot be implemented unless Mr McGimpsey signs the new contract.

Dr Tom Black, deputy chair of the BMA’s Northern Ireland GP Committee (GPC), said: “Essentially, without a contract GPs are not NHS employees and as a result we may not be insured, so we won’t be able to work.

“This is not something that GPs want to happen but we may be left with no choice. Nothing is very clear at the moment. We are still trying to ascertain the consequences of the contract not being signed but there is the very real possibility that GPs will not be able to work.”

The British Medical Association has been working to ascertain whether legal issues will stop GPs from working from April 1.

Dr Black continued: “The problem is this situation is completely unprecedented so we really don’t know what the full impact could be. We are concerned the minister may come to us and ask us to continue working on our old contract, relying on our goodwill, but we don’t even know if that will be possible.

“If he wants to make changes to the contract that has been |negotiated, he has to have a three-month consultation period which isn’t feasible in the timeframe we have. This has to be resolved urgently.”

Mr McGimpsey has played down the concerns. He said: “My budget was not given to me until March 10.

“I now have to decide how to allocate it, taking account of all the pressures on it, so as to improve services to patients wherever possible and minimise the damage of the deficit.

“It is my intention to take the necessary decisions before the end of the financial year. Northern Ireland's GPs are no differently placed from any other health sector worker in that regard and at no disadvantage in comparison with GPs in Great Britain.”

However, Dr Black said he has not received any assurances from health officials that the situation will be resolved.

“I spoke to the department on Wednesday and they were talking about the possibility of interim measures, which would suggest they don’t think the contract will be signed by April 1. Furthermore, they couldn’t give me any details about what these interim measures might be,” he said.

“The unprecedented failure of the Northern Ireland Department of Health, Social Services and Public Safety to implement the four-nation contract leaves Northern Ireland general practice in contractual limbo.

“Northern Ireland GPs — and their patients — should not be treated any differently from their counterparts in the rest of the NHS.”

Background

The General Medical Services (GMS) contract is the UK-wide contract between general practices and primary care organisations for delivering primary care services to local communities.

NHS Employers leads negotiations with the General Practitioners Committee, which is part of the British Medical Association, on changes to the GMS contract. The GMS contract was introduced in 2003 and covers a number of areas, including the cost of running a general practice and setting out clinical standards and targets.

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