THIS WEEK

The British Medical Association's decision to ballot all GPs on resigning from the NHS over an alleged lack of progress in contractual negotiations, was a completely unjustified action in the middle of negotiations that were making substantial progress, according to HSJ sources close to the discussions.

The BMA's GP committee took the decision to ballot after it alleged it could not reach agreement in six areas of negotiation.

But HSJ understands the Department of Health and the GPC had reached agreement in closed meetings on a range of issues, only for the GPC to publicly attack the lack of progress and go back on the agreements.

It is understood that a pay award on indirect expenses of around£24,000 - which was attacked publicly by the BMA - had already been agreed in meetings with DoH officials.

The ballot of GPs, which closes next week, asks if they would be prepared to resign from their current NHS contract in April 2002 if a new contract is not in place, and if the GPC has not been recognised as having negotiating rights for personal medical services GPs. However, it is understood the GPC had already conceded in principle that it cannot have sole negotiating rights over PMS.

HSJ sources spoke of GPC negotiators feeling pressured by a combination of GP discontent about workloads and a push by the full committee to do something drastic. There have also been suggestions of political motives to try to embarrass a government about to call an election.

NHS Confederation chief executive Stephen Thornton said of the negotiations: 'They hadn't reached the point where there was a clear impasse. We were taken by surprise on hearing about the ballot. One could only assume that it was internal politics. '

NHS Alliance chair Dr Michael Dixon said: 'I think that the BMA took a great risk in foreclosing at this stage and my own feeling is that the Department of Health and the government do understand the issues and are prepared to address them. '

National Association of Primary Care chair Dr Peter Smith said: 'The GPC is a trade union. It is not there to implement government policy. It has to reflect that mood and has to be seen to be strong in supporting its members' views. '

The GPC's tactics were defended by joint deputy chair and negotiator Dr Hamish Meldrum: 'We were making very little progress, so we looked at ways that would not damage patients, that would allow the profession to express disquiet and anger. '

Dr Meldrum acknowledged the GPC knew about the level of the fees award before it publicly attacked the settlement but added that it had not been 'a question of agreeing or disagreeing' with the figures, and that the GPC had 'tried to put pressure on the department' over the way the issue was dealt with.