It has been a year since I have had the honour of representing South Yorkshire nationally on the General Practitioners Committee (GPC) of the British Medical Association (BMA). As well as thanking you, I thought I would take this opportunity to share with you some of what I have learnt over the last year.
What is the GPC of the BMA?
The GPC is a subcommittee of the BMA and started out life in 1911 as the Insurance Act Committee. Its main role is to negotiate on the behalf of GPs nationally. This usually means negotiating with the Department of Health and NHS England. GPC represents GPs across the United Kingdom irrespective of their contractual status and is funded by the BMA and by LMCs through the voluntary levy which is paid to the General Practitioners Defence Fund (GPDF). You do not need to be a member of the BMA to be represented by the GPC.
Who are the GPC?
GPC comprises of 86 members (GPs) and has a varied mix of ages, sex, ethnic backgrounds and experience. To sit as a representative on the GPC you need to be elected via any one of the following routes:
Hold a seat for 3 years
LMC Conference representatives
Hold a seat for 1 year
BMA Annual Representatives Meeting
Hold a seat for 1 year
Representatives of the committee elect an executive team from the committee to represent us all. This team used to be called the negotiators (or “negs”). The Executive team carry out the will of the committee which is based upon the motions passed at the LMC conference. The current chair of GPC UK is Dr Chaand Nagpaul. Each of the devolved nations of the UK has its own Chair.
How does GPC work?
GPC meets on the third Thursday of every month at BMA house in London, except in May (because of the LMC conference). Expenses are paid for travel to and from the meeting and a dinner is held the Wednesday night before the meeting, if you want to. Expenses are also paid for the dinner and to stop over the night to attend the dinner. An “honorarium” is paid for attending the GPC meeting. This is currently £525 for a day and is taxed at source. Representatives are not paid for work undertaken outside of GPC. So attending LMC meetings or local gatherings is unfunded, however a representative is eligible to claim an honorarium if attending work on behalf of and sanctioned by the GPC. There is plenty of scope for representatives to become involved with the GPC outside of its monthly meetings.
Every month GPC meets to discuss various issues. Most of these are confidential so it is always hard to feedback on what exactly is discussed, however Pulse and GP magazine usually seem to know somehow. What I can say, is that it’s all the things that you would expect and hope would be discussed. Most of the time it is timely and relevant, but sometimes GPC is behind the curve and discussing topics that grass roots GPs have been contending with for months, or even years. GPs see the result of the GPC discussions in the GPC newsletter and in Dr Chaand Nagpaul’s monthly newsletter. LMCs tend to dissect these and forward relevant information to you in their own newsletters.
The role of the elected representative is to feed into the GPC and to feed back to GPs and LMCs. This creates what is known as the GPC-LMC-GP axis. So, grass roots GPs are able to feed up to GPC via their LMC of their regional representative and GPC is able to trickle down to grassroots GPs in the same way.
In between meetings, GPC members communicate constantly through an email system known as the list server.
GPC meetings and the list server are often dominated by a few vocal individuals who are very experienced in medical politics. For some, GPC is a career and being heard is important. For others, a few select words at the appropriate time are the best way to get across a short pertinent message.
How have I represented you so far?
I have delivered to GPC the message from South Yorkshire that GPs are overworked and strained to breaking point. I have asked for stability in our contacts, guidance on how to say no and what to say no to and no new schemes. I have asked for clearer communication between the BMA/GPC and GPs in the form of reorganisation of the BMA website. I have also asked for the regional GPC role to be a clear job with a job description and access to resources that can be used locally so that I or my successor can bring GPC to you, rather than you having to reach out to it.
GPC does an incredible job to help defend and further the role of General Practitioners. GPC and the BMA are not good at communicating their successes to grass roots GPs and I believe that there exists resentment toward GPC from grassroots GPs because of a lack of understanding of how hard GPC already works for us.
However, GPC can and must be better. The committee is bloated and slow to make decisions meaning that the problem has often moved on before GPC has resolved it. Its method of communicating between committee members in my opinion is antiquated and does not grasp new technologies. The relationship between the BMA and GPC is obviously politically charged and the committee itself is boiling over with political wrangling. None of this will help us attain the modern, efficient and effective leadership we need to guide us through the hardest time that General Practice has seen since its inception.
In my opinion, we have at our disposal the right people, but not the right systems. As I represent you - please tell me if you believe that I am wrong.
I am but one small cog in the system and my work in the GPC continues for a further two years…