England’s health minister has gone over the heads of union negotiators to accuse the British Medical Association of being unprofessional.
GPs across England have received a letter from Health Secretary Wes Streeting accusing the British Medical Association GP committee chair – who is currently leading a formal dispute against the government – of acting in a “deeply unprofessional” manner.
From 1 October, GP practices in the NHS have been required to accept online consultations and questions from patients between the hours of 8am and 6:30pm each weekday.
These rules were imposed as part of a new contract for GPs (who are technically independent contractors for the NHS) which was negotiated and approved by the BMA in February of this year.
The BMA’s position is that the government has not meaningfully engaged with the GP committee (GPC) to deliver necessary safeguards prior to 1 October, which was one of the terms of GPC England signing off on the new contract.
What the GPC is asking for includes safeguards like flexibility for practices to suspend online triage if they become overwhelmed or feel that safe care is threatened, and increasing practice resources to manage online requires and queries beyond the mandatory 8am to 6:30pm timeframe.
Australian GPs may be somewhat familiar with the BMA’s core argument.
“GPC England has repeatedly said that patient access must be clinically safe,” it said.
“To ensure that happens, practices must retain the ability to manage their consultation systems safely, including when demand exceeds safe capacity, rather than being forced to prioritise convenience over patient need in a woefully under-resourced environment.”
Part of the problem is that, if an online query is marked “urgent”, the software will automatically decline the request and instruct the patient to go to an emergency department. To get around this, some patients have marked urgent queries as routine.
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According to a survey conducted by the BMA, 70% of GP practices have received requests that were submitted as “routine” or “admin” that were actually for urgent conditions.
Around 42% of those practices said they had cut face-to-face appointments to address the volume of online queries.
In his letter to GPs, Mr Streeting referenced a speech at the 2025 England Local Medical Committees from GPC England chair Dr Katie Bramall.
Referring to the ongoing online access dispute, Dr Bramall reportedly accused the government of being “traitors” to the profession and of “disingenuousness”, “duplicity” and “gaslighting”.
“I am a staunch supporter of the trade union movement, but serious relationships with government demand a certain level of mutual respect and professionalism,” Mr Streeting’s letter said.
“Your union representatives are currently making it impossible for me and my officials to engage in good faith in the way we would all want.”
In response, Dr Bramall reiterated that the BMA was concerned for patient safety.
“We have repeatedly sought to work with the Government all year to make their aspirations a safe success but, in recent weeks, attempts have been thwarted by incessant media briefings and nameless sources engaging in what I can only call relentless attacks on the integrity of the profession,” she said.
“However, we stand ready to put things right, as is our duty to the staff and patients we represent, to ensure care is safe for patients and practice staff to move forward constructively.”
