Will Collective Action Heal or Harm the NHS?

By Kirsty Morris

As the NHS faces critical challenges, the debate between the BMA and the government over GP practices taking collective action continues to unfold. At the heart of this discussion is a proposal and action from some GP practices to limit the number of patient appointments to 25 per day per doctor. While proponents argue this protects doctors’ well-being and ensures better care for each patient, opponents warn that this approach could lengthen waiting times and exacerbate health issues.

Here are some of the key opposing insights from industry professionals on this controversial proposal.

Limiting Appointments to 25 Per Day: The Argument for Collective Action

Many GPs, overwhelmed by increasing patient demand and longer working hours, are supportive of limiting the number of daily appointments. Dr. Steve Taylor of Doctors’ Association UK pointed out that limiting appointments to 25 a day would result in the loss of around four million appointments, which could have far-reaching consequences. However, he sees this as a necessary step to address the workload issues GPs are facing. ​(Pulse Today).

Supporters of collective action argue that the current system prioritizes quantity over quality. By capping appointments, they believe GPs can spend more time with each patient, leading to more thorough diagnoses, better management of long-term conditions, and ultimately, improved patient outcomes.

Simon Braybrook, a GP, suggested that limiting appointments to safe levels is not industrial action but common sense. He argued that GPs should not take on unfunded work or work beyond their capacity​ (Pulse Today).

The Patient Impact: Longer Waiting Lists and Delayed Care?

On the other hand, critics, including the Health Secretary, Wes Streeting, warn that limiting appointments will have serious consequences for patient access. A cap of 25 appointments per GP could lead to longer waiting lists, delays in diagnosis, and worsening health outcomes.

Matthew Taylor, CEO of the NHS Confederation, warned that if GPs cap patient appointments, it could have a “catastrophic effect” on the NHS as a whole. He highlighted that general practices are already supporting more patients than before the pandemic, and any reduction in their workload would increase pressure on other services like A&E ​(Pulse Today).

Dr. Amanda Doyle, a director at NHS England, expressed concern that while GPs may not intend to harm patients, this action could have a “detrimental effect” on the system. She emphasized that NHS England wants to work with GPs to make general practice fit for the future, acknowledging that practices have been under huge pressure​ (Pulse Today).

Streeting’s stance reflects these fears, warning that limiting appointments could harm patients and overburden other NHS services, such as urgent care. In an appearance on BBC Radio 4’s Today programme, he said that collective action of this nature would “harm patients and put more burden on their colleagues in other parts of the NHS.”

Is there a workable middle ground?

The debate, however, remains heated. Some fear that without significant reform, limiting appointments will only be a temporary fix. Others argue that without such a change, GPs will continue to struggle, and patients will suffer from inadequate care.

What are your thoughts?

• What are your thoughts?
• Do you favour collective action or are you looking to continue seeing higher numbers of patients?
• Where do you think the middle ground is?
• Do you think is a workable middle ground?

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