Why are West Midlands GPs so angry?

We’re at a tipping point that could be bad for doctors and worse for patients

Good morning Patchers — “The protests in Birmingham were the first shots fired in a war to save general practice,” writes Dr Mark Williams about the May GP demonstrations in today’s story. The war is far from over — this autumn GPs will be ‘working to rule’ or refusing to work beyond their contracted hours and duties in an attempt to make the government sit up and listen. If, like us, you weren’t exactly sure what the fuss was about, Mark is here to explain why GPs like him are so angry (and why changing things could benefit public health as well as working conditions).

To read Mark’s brilliant writing in full, you will need to become a Dispatch subscriber. That’s because (much like primary healthcare) local journalism is under threat. Big media companies that treat articles more like billboards for plastering adverts all over are unfortunately the norm in this industry. Fear not — The Dispatch is here to change that. For £8 a month you’ll get all of our writing directly to your inbox — and you’ll feel the warm glow that comes with supporting a local venture.

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Brum in brief

🚆Transport probe: West Midlands Combined Authority mayor Richard Parker is expected to appoint an independent reviewer to investigate delays to transport infrastructure projects. The Camp Hill line and the Brierley-Wednesbury Metro are among those schemes to be probed. Mr Parker said: “I want the review to commence as soon as we’re through the summer with a view to the initial findings being reported before the end of autumn.” The mayor, celebrating the first 100 days in his new role, said transport project delays were the biggest challenges he has faced so far. Full story.

🏚️Dystopian Brum: A university study has mocked up an image of central Birmingham to show what it might look like without the hospitality and tourism sector. The results are dystopian — the Mailbox is pictured broken, decaying and without it’s usual verve. The research by Arden University found that 86% of people believe the sector only offers short-term career prospects, despite being worth circa £91 billion nationally. This, says Dr Emmanuel Murasiranwa, Principal Lecturer for the School of Hospitality and Tourism, needs to change. “In other parts of Europe, people view working in hotels and tourism as a fulfilling and sustainable career. Unfortunately, this outlook isn’t as prevalent in the UK,” he said.

🏊Dudley indecision: Cash-strapped Dudley Council is undecided on how best to outsource leisure centre services in an attempt to save money. The authority is offering a ten-year deal with £60m to take over services, being up front about how much work needs to be done, including a half-million-pound repair of Crystal Leisure Centre roof in Stourbridge. Full story.

🐛Family summer party: Botanical Gardens is hosting a three-day family extravaganza this weekend: The Lady Bug’s Ball. It's a bonanza for families with live DJ sets, puppetry, art workshops, arts performances and poetry for all the family. You also get full access to the gardens and playgrounds with your ticket. More here.

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Why are West Midlands GPs so angry?

By Dr Mark Williams

Why are GPs so angry? They have it all; money, status, power, cardigans.  Yet in May this year, over one hundred of these pill pushers and fifty of their supporters marched through the centre of Birmingham. What were they protesting — and what will happen if they don’t get what they want? As a GP partner (both a GP and one who co-owns his practice), born in Birmingham and now practising in Staffordshire, I feel well placed to answer this.

I didn’t attend the event but speaking to those who did, I get the sense that the protest was a rare but surprisingly joyful one. Finally! We were demanding the basic respect I believe we’re entitled to. There was real anger at both the then-Tory government and at NHS England. The GPs were angry at the increasing workload; the reduction in core funding (that’s the money that goes directly to practices, allowing them to employ more GPs). There was also resentment about the sense that traditional, partner-led, general practice is being undermined. 

Both Labour and the Conservative health secretaries have indicated that they favour a completely salaried service — in which GPs work for someone else. This is dismaying, since after 13 years working as a general practitioner, I’m convinced that the GP partner model (in which GPs own their practices) is better for everyone — the GPs themselves, and our patients’ chances of staying healthy. More on this later.

East End, London July 5th 2014. Photo: In Pictures Ltd./Corbis via Getty Images.

Besides this, NHS England continues to reduce the funding to general practice. This seems unfair — general practice is seeing greater numbers of patients, while they give millions to hospitals with reduced productivity. 

One point that the protesting GPs were keen to make was how general practice acts as a foundation for the NHS — a common sense claim that makes the more recent stats about our region all the more worrying. In the West Midlands, between 2014 and 2024, the population increased by 11.7%. In that same period, the number of full-time GPs fell by 15.5% and the number of full-time partners fell by 27.5%.

Dr Chandra Kanneganti, CBE, a GP working in Stoke-on-Trent, was just one amongst the many at the protest. He told me he was protesting to “highlight poor GP core funding”, amongst other issues. A below-interest rise in funding (1.9% per patient) means that many practices will struggle with increasing costs including staff wages. At this point, we have to ask ourselves: are doctors exaggerating? 

Papers like the Daily Mail love to promote a myth about GPs — that we’re paid far too lavishly, and this is why us lazy buggers only work part-time. It’s ironic that, mostly, the exact opposite is true. Many GP partners in Birmingham and the West Midlands are unable to afford to work full-time in their practice and take second jobs in hospitals and/or in the ever-increasing private sector, to keep their practice viable. The income from their practices is shrinking and is now unreliable.