GP leaders vote to move to dentist-like NHS and private model

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By Daniel Pye

GP representatives have voted in favour of moving towards a “hybrid” NHS and private service model because general practice is “no longer financially viable”.

In response to a motion at the local medical committee (LMC) conference in Belfast, GP leaders from around the UK agreed to the need for a "Plan B" for primary care, which would likely be a means-tested subscription-based service similar to dentists.

It comes as English GPs have started taking collective action against the government following the latest General Medical Services (GMS) contract, which the BMA’s general practitioners committee (GPC) says put extra burden on GPs through unlimited appointments without the funding to meet it.

The motion said current GP contracts are failing patients and practices alike, that more GPs are opting to work outside the NHS.

To address this, it called for contracts that permit GPs to provide private services to their NHS patients when they are not contractually available.

And it said a move towards a hybrid NHS and private GP service “is the only option for the future”.

GPs at the conference also voted for a strategy for exiting GMS contracts and future working outside the NHS.

And agreed to direct the UK GP committee (GPC) to work with all GPCs “to ballot the profession on a plan B option for general practice provision that includes consideration of a means-tested, subscription-based service, such as those being offered currently by NHS dentists".

Doctors at the conference convincingly passed all parts of the motion.

Before the vote Dr Maitiú Ó Faoláin, from the Irish Medical Association, shared his experience of the mixed public/private model in the Republic of Ireland.

He said that the model had not increased health inequalities for more deprived communities, as those on lower incomes can apply to have their primary healthcare covered – it was only top earning patients who had to pay.

Bringing the motion to conference, Dr Michael McKenna representing Northern Ireland Eastern, said: “General practice is at breaking point. The current NHS contract model is no longer capable of sustainable workload.”

Mckenna said his motion did not replace the NHS, but gave GPs “leverage” as ultimately, they did not have an alternative model to turn to if negotiations between the government and the GPC over the contract broke down.

Dr Samantha Fenwick, from Grampian, said she would not vote for the sections of the motion referencing the UK, as Scotland and Wales had achieved pay deals for GPs.

However, Dr Frances O’Hagan, chair of BMA Northern Ireland’s GP Committee, said it is up to the devolved committees to decide whether they want to accept a motion voted through the LMC conference.

McKenna also added: “Wales and Scotland have done very well in terms of funding – you still need another option.

“You might be in the same position as [England and Northern Ireland] five years down the line.”
Pulse reported that after the motion in an update to conference, GPC England chair Dr Katie Bramall said her committee will meet next to determine “if we wish to progress with a ballot”. She had urged GP leaders to think “very carefully” about the implications of Plan B earlier in the conference.

On 1 May, English GP practices stopped sharing patient data with other organisations as a collective action in protest of the 2026/27 GMS contract.

The GMS was overwhelmingly rejected by 17,000 BMA GP members in March.

The Department for Health and Social Care has been approached for comment.

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