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GPs in Scotland vote to accept new contract

BMJ 2018; 360 doi: https://doi.org/10.1136/sbmj.k297 (Published 22 January 2018) Cite this as: BMJ 2018;360:k297

Rapid Response:

Re: GPs in Scotland vote to accept new contract

The BMA in Scotland having spinning this result furiously and claiming it as some kind of ringing endorsement when nothing could be further from the truth.

They claim "some rural GPs " voted No when in reality the vast majority voted No along with many in deprived urban practices - the so-called Deep End practices.

But BMA Scotland refuses to realease the vote by LMC. Why is that? Are they frightened it will show a clear rural urban divide?

They talk about the "vast majority" of Scottish GPs supporting the proposals when in reality the turnout was 39% and about two thirds of them voted Yes. So in reality only 28% of Scottish GPs have openly endorsed the proposals.

My no vote was my means of telling OUR trade union reps that I feel they have not done a good enough job.

It's not a trade union's job to produce a deal with which a significant proportion of members (both rural and Deep End) disagree with profoundly.

The promised £250 million is NOT going directly to practices. Past experience tells me that whenever health boards get more money for "primary care" very little filters through to practices.

With health and social care integration I think we will be even less likely to see our fair share of the "new money".

This contract puts almost every rural practice (and many Deep End) on income support which is in its own way a destabilising influence.

It fails to redistribute in favour of Deep End deprivation and inequality.

It does not recognise rural deprivation at all or the significant extra level of responsibility taken on by rural GPs.

It does nothing to support, enhance or promote fragile rural practice.

It makes promises about services been taken off the hands of GPs much of which is simply not going to be feasible in rural areas.

It enshrines a situation where rural GPs consistently earn about 20% less than urban colleagues despite broader responsibilities and higher expenses and living costs. We are de facto the poor country cousins. How does that help recruitment and retention?

We are told they well get round to sorting rural in 3 to 5 years when it needed sorting in 2004.

Throughout the last 2 months the legitimate concerns of Deep End and rural GPs have been met with what stuck many of us as a patronising and condescending response from BMA Scotland. They have certainly not done themselves any favours with many rural and Deep End GPs and they will lose members as a result.

These proposals are a proverbial curate's egg and I for one don't want something that's "good in parts"

Competing interests: No competing interests

22 January 2018
Steve McCabe
Remote rural GP
Portree Medical Centre, Portree