GP Exodus Looms as Health Minister Mike Nesbitt's Funding Stance Sparks Fury

The Royal College of General Practitioners (RCGP) has joined the criticism of the funding proposals voiced previously by the British Medical Association (BMA).

The Royal College of General Practitioners states that the minister's approach to the issue has "further disheartened" general practitioners, and warns that his behavior may cause additional doctors to resign.

The British Medical Association (BMA) serves as the trade union for doctors and handles negotiations regarding the funding agreement with the Department of Health, referred to as the "GP contract." The organisation counts approximately 1,300 general practitioners among its membership in Northern Ireland.

Meanwhile, the RCGP oversees the training of general practitioners; to practise, for example, they must pass an RCGP examination. The organisation boasts approximately 1,400 members within the province.

The entire controversy revolves around the revisions to the GP contract for the period of 2025/26.

The British Medical Association stated that the department proposed an extra £1 million in core funding per registered patient; additionally, they suggested providing £3.5 million to offset the increase in National Insurance contributions; furthermore, they planned to allocate £5 million to address GPs' "indemnity," which refers to the mandatory insurance coverage required for each general practitioner.

The agreement included 17 conditions aimed at simplifying the process of scheduling an appointment with a general practitioner.

The British Medical Association presented this agreement to its members, who declined it.

It was seeking an additional £80 million in core funding (along with expanding the suggested indemnity support to include locum doctors as well as General Practitioners tied to specific surgeries).

Mr Nesbitt stated on Monday that he would proceed with the new contract regardless.

It remains to be observed what actions the BMA will take; its general practitioners are unable to initiate a full-scale strike because of their contractual duties, but could choose to reduce the number of patients they treat, among other options.

Now Dr Ursula Mason, who chairs the RCGP, has stated that physicians are "upset" by Mr Nesbitt's "unparalleled action."

She stated that a key reason for the challenge in securing GP appointments is "persistent underinvestment".

She stated that we have a limited number of general practitioners, a restricted number of additional healthcare professionals available to assist patients, and only so many appointment slots we can provide each day.

The minister's remarks have added to the demoralisation of an already worn-out workforce, and their effect on the profession shouldn’t be downplayed.

GPs and their staff aim to guarantee that all their patients receive safe, suitable, and prompt care. However, demand is increasing: despite the rise in registered patients, full-time equivalent GP numbers have declined, even as we conduct around 200,000 appointments each week.

General Practitioners have been delivering increasingly more services with progressively fewer resources but cannot sustain this approach indefinitely.

A lot of our general practitioner peers are exhausted due to rising numbers departing from the field, attributing their departure to heavy workloads and staffing issues.

The increase in surgical contracts being handed back [facility closures] over recent years highlights the financial and staffing difficulties encountered by dedicated general practitioners striving to provide optimal patient care.

We have concerns that implementing this contract might exacerbate the issue, especially if substantial extra funding does not accompany it.

Mr Nesbitt stated: "Upon taking office, my primary objective was not to engage in conflict. I hold deep admiration for the countless dedicated professionals who consistently provide exceptional medical care here in Northern Ireland..."

That being said, my intention was never to make pledges I couldn’t uphold or consent to requests that the budget absolutely couldn't meet.

In Northern Ireland, the typical income for a GP partner (a GP who owns their practice) stands at approximately £108,300, whereas the average salary for GPs working under these partners amounts to about £63,100.

The total income from both sources is several thousand pounds less than the typical amount in England, Scotland, or Wales.