GPs in England are to stage industrial action for the first time in 60 years amid a row over funding, a move that experts have warned could have a catastrophic effect on the entire healthcare system.
In a ballot run by the British Medical Association (BMA), family doctors voted overwhelmingly in favour of taking collective action in protest at the previous government increasing their budget by only 1.9% this year.
More than 8,500 GPs took part in a vote, the BMA said, with 98.3% backing collective action. The disruption is likely to begin immediately and could last months.
GP partners will choose what form of industrial action to take from a selection of 10 measures set out by the BMA, the Guardian understands, and could bring the NHS to a standstill.
One option is to limit the number of patients GPs will see each day to 25. They may choose to stop performing work they are not formally contracted to undertake, and could ignore “rationing” restrictions by “prescribing whatever is in the patient’s best interest”.
Family doctors could also refuse to share patient data unless it is in the best interest of the patient, and refer patients directly to specialists rather than following NHS processes.
The development poses an enormous headache for Wes Streeting, the health secretary, just three days after he resolved a long-running pay dispute with junior doctors.
Junior doctors’ leaders in England agreed to a new pay deal with the government on Monday, which could lead to their wages rising by 22.3% over two years.
The last time GPs took “collective action” was in 1964, when family doctors collectively handed in undated resignations to the Wilson government. This led to changes, including the Family Doctor Charter of 1965.
The BMA said the new GP contract, which will increase funding for services by 1.9% in 2024-25, means many surgeries will struggle to stay financially viable.
Dr Katie Bramall-Stainer, the chair of the BMA’s GP committee, said: “We had a huge response to this ballot, and the results are clear – GPs are at the end of their tether. This is an act of desperation. For too long, we’ve been unable to provide the care we want to.
“We are witnessing general practice being broken. The era of the family doctor has been wiped out by recent consecutive governments and our patients are suffering as a result.”
Bramall-Stainer said the action would be a “slow burn” rather than a “big bang”.
But patient groups said industrial action was “selfish” and warned that GPs risked harming those in need of care and losing the public’s support.
NHS leaders warned that wider NHS services would experience knock-on effects.
Saffron Cordery, the deputy chief executive of NHS Providers, said: “Relentless pressure on primary care, plus many practices closing across England, means patients are turning to already busy accident and emergency (A&E) departments to seek help.
“Today’s announcement means even more patients understandably will turn to under-strain A&Es and other highly pressurised services including 111, ambulances and mental health support.”
The Royal College of GPs said the ballot result showed the “strength of feeling” among family doctors in England.
Its chair, Prof Kamila Hawthorne, said: “No GP will want to restrict the services they provide for their patients – and it needs to be made clear that GPs and their teams will still be working.
“But there are many aspects of what GPs provide that go well beyond the contractual requirements they are under, and this additional workload and the goodwill of the GPs delivering it, have been taken for granted for too long.”
Within minutes of the ballot result being announced, NHS England urged the public to continue to come forward for care as normal.
Practices will still be required to open between 8am to 6.30pm Monday to Friday.
Dr Amanda Doyle, the NHS national director for primary care and community services, vowed to work with ministers to find a resolution to end the industrial action.
“Our message to the public remains the same – they should continue to come forward for care during this collective action, as GP practices will remain open,” she added.
The NHS recommends patients should use 111 for urgent medical help when their GP practice is unavailable and if it is a serious or life-threatening emergency to call 999.
The ballot result came hours after ministers announced plans to cut red tape to enable GP surgeries in England to hire more doctors.
Officials said the move was an “emergency measure” while the government “works with the profession to identify longer-term solutions to GP unemployment and general practice sustainability”.
The King’s Fund, a health thinktank, welcomed the move. “While it’s only a sticking-plaster solution, it should help end the absurdity of GPs struggling to find jobs at the same time that patients are struggling to find GP appointments,” its co-director Alex Baylis said.
