It’s never happened before, and of course it may not happen, but in the latest episode of the Practice Index Practice Manager Panel podcast, our panel reached the conclusion that, ultimately, industrial action may need to be considered. And not in the far distant future – potentially as early as next year.

What’s leading us to a point where general practice may have to take such drastic steps?

The chronic lack of investment in the service and failure to attract enough additional GPs, even to replace those who are leaving, are both well-documented issues and nothing particularly new. What is new is that politicians from both of the main parties seem to be attacking the service in unparalleled ways.

What really provoked the panel this week were the recent comments made by the leadership of the Labour Party. They’ve stated that the GP contract is “murky” and “opaque” and that, as a result, they wish to abolish the independent contractor status of practices and make them a full part of the NHS.

This desire to, in effect, nationalise general practice is of course what the Labour Party wanted to do back in 1948 when the NHS was first formed. Since then, however, there has been little attempt made to change this situation. Until now. Now it seems it’s the Conservative Party who are the ones defending the value of the GP contract.

In recent years, GPs have been regarded as politically untouchable because of their huge popularity with the general public. For the first time (perhaps due to negative media campaigns against practices), politicians see an opportunity to play to the populist agenda. The implication is that by somehow bringing practices into the NHS fold, the perceived challenges of access within general practice will be resolved, without explaining how they would actually make this happen.

What our panel rightly point out is that the burden practices and partners carry as contract holders will very likely be put down in a salaried scenario. As far as I can see, there seems to be little doubt that imposing NHS bureaucracy on the service will only make matters worse.

But just because it’s not sensible doesn’t mean it won’t happen. It seems that national GP leadership is not being taken seriously. Last year, the NHS imposed a contract without a negotiated agreement with the GPC for the first time that any of us can remember. Everyone expects the same thing to happen this year. If the proposed new deal, which will start in 2024, is unsatisfactory (and how many of us believe it will be anything but), what happens then?

This is where the panel indicated that strike action may have to be considered. If the government and NHS hierarchy won’t listen or even negotiate with GP leaders, then it may fall to practices to rectify the situation. And how else could this be done without considering industrial action?