The BMA Northern Ireland chair has opened the country’s first ‘hybrid’ GP practice, which will take on private patients, in a bid to survive.
On Tuesday, Dr Tom Black, a GP partner at Abbey Medical Practice in Derry, opened up the surgery to paying patients who are not already on his 6,800 patient list.
He told Pulse that the clinic had “absolutely no choice” in this matter, otherwise the clinic would have closed.
Abbey Medical Practice has been running a monthly deficit for more than a year due to “insufficient funding” from Northern Ireland’s Department of Health.
Dr Black said the practice had a “huge overrun” after giving staff an 8% raise last year because there was no central funding for the DDRB-recommended 6% raise. Ta. Without this raise, the receptionist would have faced a workforce crisis. Leave for a better paying job at a supermarket.
From now on, income from private patients – who are charged £75 per appointment – will go entirely towards NHS care and overdraft repayments.
Dr. Black emphasized that doctors who see private patients will work for free.
“I worked for free on Tuesday. I don’t get paid, I don’t get a replacement day,” he said.
“We will ensure that we continue to have the same number of appointments and the same number of doctors in NHS practice. But those same doctors will work more in private on their holidays,” he added.
The BMA NI chairman told Pulse that the move was “transformative” and that he was “totally confident” it would be successful, given the high demand for private appointments in his region due to long waiting lists. “I have it,” he said.
He said the same hybrid model could be replicated in other struggling practices in Northern Ireland, and several GP practices had already contacted them to ask how the model had been implemented.
“My impression as BMA leader is that given the department’s lack of funding, GPs will need to strive for self-sufficiency to maintain the integrity of the service,” Dr Black said.
In response to Dr Black’s new hybrid model, GP Committee NI Chair Dr Alan Stout wrote: Post to X: “We will listen carefully to a GP with 40 years’ experience in perhaps the most challenging demographic in all of the UK.
“If it doesn’t work out for Tom Black, it won’t work for anyone else. This is the beginning of the end for the NHS as we know it.”
Last year, Dr Black told Pulse that despite the Department of Health (DoH) rejecting his initial application, he took steps to close the practice’s list to new patients due to an unmanageable workload.
Dr Black emphasized that his surgery is located in a very deprived area and patients can wait five to six years for second-line treatment.
LMC leaders across Northern Ireland recently voted in favor of a “thorough review” of whether industrial action is an option for GP partners, calling out the DoH’s “inaction” in dealing with pressures in general practice. “I’m appalled,” he said.
In an exclusive interview with Pulse last year, Dr Stout said GPs across the country could end their NHS contracts and come up with “alternative options” if the problems facing doctors were not resolved.
From July 2022 onwards, 19 clinics across NI have returned their contracts. During that time, the country had no chief minister or deputy chief minister, and civil servants were only allowed to make decisions in accordance with policies previously set by ministers.
And government investment in general practice fell by 7% in real terms between 2021/22 and 2022/23.