Scottish GPs resign from BMA in protest at new contract

Authors: Gareth Iacobucci 

Publication date:  22 Feb 2018

A group of GPs in Scotland are resigning from the BMA in protest at the agreement of a new contract that they claim will have a “devastating” effect on patients in rural areas.

Although the contract was accepted by a majority of GPs in Scotland who took part in a BMA ballot,[1] 28% rejected it, with the strongest opposition coming from doctors in rural and deprived areas, on the grounds that the reworked funding formula shifts money to urban practices with elderly patients.

After the ballot the BMA responded to the criticisms by establishing a working group to ensure that the contract was delivered in a way that worked for rural areas.

But in an open letter to BMA leaders 10 GPs from rural and urban parts of Scotland said that they did not think the response to their concerns was adequate. The GPs, three of whom have been BMA members for at least 25 years, said that they had already resigned their BMA membership, were intending to do so, or were considering doing so “because we believe there has been a serious breach of trust between the SGPC [Scottish General Practitioners Committee] and its electorate.”

Cathy Welch, a GP on the island of Arran and one of the resignation letter’s signatories, was one of six doctors to respond to the story about the contract vote on,[2] in which she warned that the new contract would make recruitment and retention in rural areas even harder.

In the resignation letter the group of GPs accused the committee of sending out a “highly biased endorsement” of the contract alongside the ballot papers that didn’t include information on the potential winners and losers of the new deal and the relative effect of the new allocation formula on rural practices.

The letter also accused the committee of overplaying the profession’s endorsement of the new contract after the ballot. Commenting on the ballot’s modest turnout of 39%,[3] the GPs argued, “The contract was not endorsed by the majority of general practitioners who either did not vote or who voted to reject it.”

The letter said, “The new contract will have devastating effects on patients in remote rural areas who have no alternative provider of medical services: these areas already have the most difficulty recruiting GPs to substantive and locum posts and they will now no longer be able to compete with urban practices whose partners are already paid substantially more than rural GPs and have now gained substantial extra funding.”

It added that patients living in Scotland’s most deprived areas would also suffer as a result of the new allocation formula.

Citing what they described as an “inexorable decline” in GPs’ income in absolute terms and relative to that of hospital doctors since 2004, the doctors said that they believed the BMA to have been “a weak advocate for general practice.”

“We are actively seeking an alternative structure to represent Scottish GPs and their patients more effectively,” the letter said.

Alan McDevitt, chair of BMA Scotland’s General Practitioners Committee and one of the three BMA leaders to whom the letter was addressed, said, “The new GP contract was given clear backing by the profession, with 71.5% of GPs who took part in the poll backing the contract and extensive feedback from the range of consultation events that were held across Scotland, including strong support from local medical committees.

“The new contract will reduce the business risks faced by GPs, address spiralling workload demands, and help to encourage more doctors to choose careers in general practice. It addresses the relative underfunding of practice workloads associated with elderly and deprived populations, while ensuring that the finances of every practice are protected.

“It is always regrettable when any doctor chooses to end their BMA membership, and I hope that in time they will reconsider. As a profession we are always at our most effective when we are united.”


  1. Christie B. GPs in Scotland vote to accept new contract. BMJ  2018;360:k297. [Link]    [Link] .
  2. Welch CJ. Re: GPs in Scotland vote to accept new contract. BMJ Jan 2018. [Link] .
  3. BMA. General Practitioners Committee Scotland: GP contract poll results. Jan 2018. [Link] .

Gareth Iacobucci The BMJ

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