Everyone Out! Is Industrial action for GPs back on the cards?
At this point, the dispute between the BMA and the government feels both baffling and inevitable. For those of us still trying to do right by the patient in front of us, it’s a depressing reminder of how fragile — and how essential — general practice has become.
There is no serious disagreement that the conditions and resources in primary care have deteriorated dramatically over the past decade. GP numbers have fallen despite a growing, ageing population with more complexity, frailty and multimorbidity. According to NHS Digital’s General Practice Workforce series, the number of fully-qualified, permanent GPs has declined steadily since 2015 even as demand has risen.¹
Inevitably, this has led to rising public dissatisfaction (ask any MP what fills their inbox) and a healthcare system pushed ever closer to crisis by avoidable hospital activity. This situation benefits no one. The decline of primary care is a lose-lose-lose for GPs, politicians and — above all — patients.
More Than a Contract Dispute
Although the current argument focuses on contract changes to open up online access, this is only the surface layer. Beneath it lies a deeper, structural problem: the simple fact that general practice no longer has the capacity, stability or resources to deliver the care the NHS claims to value.
If we want to avoid a conflict that ends in mutual destruction, we need to build something far more ambitious than another hurried negotiation. We need a new settlement for general practice — one that actually matches the scale of the crisis.
The Strange Reality: Everyone Wants the Same Thing
What’s especially striking is how aligned the core goals really are.
The government wants care shifted out of hospitals and improved access to GPs.
The health system cannot remain solvent while pouring more money into hospitals; earlier intervention is better for patients and cheaper for the NHS.
GPs want to provide accessible, relational, high-quality care — but can’t do so under current pressures.
Patients overwhelmingly want local, timely care before their problems escalate.
These are not different goals. They are the same goal expressed from different positions.
Yet we’re nowhere near achieving them.
A Deal Worth Making
The only way forward is an honest, ambitious deal.
That means a significant shift of funding, staff and stability into primary care, matched with a clear commitment from general practice to improve access, strengthen prevention and reduce avoidable hospital activity.
Like any meaningful agreement, this must flow both ways:
Investment for measurable improvement
Transparency for trust
Stability for delivery
This is not complicated to understand — only hard to build.
The Missing Ingredient: Leadership
To turn shared goals into shared action we need something in very short supply: leadership.
Not just from ministers. Not just from the BMA. But from anyone willing to articulate a common future instead of revisiting familiar grievances.
Without that, the outlook is bleak: worsening access, more pressure on hospitals, growing public frustration and political consequences that will not be easily forgiven.
General practice can still be the foundation of a sustainable, humane NHS.
But only if we choose to build that foundation — together, and quickly.
Footnotes
¹ NHS Digital, General Practice Workforce, 31 January 2025 (England). Available at: https://digital.nhs.uk/data-and-information/publications/statistical/general-and-personal-medical-services/31-january-2025
² McManners, Joe. Beyond the Waiting Room: Reimagining Primary Care for the Next Decade. NHS Confederation, 17 April 2025.
Available at: https://www.nhsconfed.org/publications/beyond-waiting-room-reimagining-primary-care-next-decade