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BEDFORDSHIRE &
HERTFORDSHIRE LOCAL MEDICAL COMMITTEE
ABOUT LMCs
 | What is a Local Medical Committee? |
The Local Medical Committee is the statutory
body, recognised by successive NHS Acts as the professional
organisation representing individual GPs and GPs as a whole to the
Health Authority, PCTs, and soon StHAs.
The 1999 NHS Act extended the LMC role to
include representation of all GPs whatever their contractual status. This
includes GPs in Primary Care Act Pilots, GP non-principals and GP
registrars.
The LMC represents the views of GPs to the NHSE,
and to any other appropriate organisation or agency.
| Independence |
The LMC is an independent self-financing body
with statutory functions. It is not a trade union. LMCs have been in
existence since 1911, and constantly modernise to work effectively
with the changing NHS.
| Funding |
The LMC is funded by a statutory/administrative
levy paid by all GPs, whether GMS or PMS. The cost is dependent upon
the number of patients on an individual list and is covered by the
expense component of the national pay award.
In addition to the statutory levy, GPs are asked
to contribute to a voluntary levy, which is used to finance the LMC’s
contribution to the national GMS Defence Fund which supports legal
cases which are of significance for all GPs.
| Elections |
Elections take place regularly under terms
stipulated in the LMC constitution which is approved by the Secretary
of State for Health. Any GP may stand for election and we have
constituencies on a PCT basis.
| Core Values |
The LMC wishes to ensure a high quality service
is delivered to patients within the resources available and is keen to
see the development of primary care.
The LMC is committed to the values of:
 | Equity and Fairness |
| Openness |
| Equal opportunities |
| Representativeness – working to ensure
that all advice we provide is representative of all GPs |
| Representation |
Wherever possible, the LMC works co-operatively
with the Health Authority, PCTs and other organisations to ensure
patients receive services and care in accordance with the profession’s
local and national priorities.
Wherever necessary, the LMC robustly defends the
profession’s views when those of others conflict with what we
believe is in our patients’ best interests.
The LMC represents and advises on all matters
concerning:
GPs as providers of NHS services:
| GP contracts, both independent and
salaried, both GMS and PMS |
| The NHS regulations, the GPs’ Terms of
Service and the PMS (Personal Medical Services) equivalent |
| GPs as providers of ‘intermediate care’
and enhanced GMS |
| Local Health Authority and Primary Care
Trust (PCT) policy, including Primary Care Implementation Plans
(PCIP) and the Health Improvement Programme (HimP) |
| The NHS complaints process and disciplinary
procedures |
| Liaison with other agencies, including CHCs,
local authority Social Services, voluntary services |
Commissioning services:
| PCTs introduce a radical new system of
organising the commissioning of Hospital and Community Health
Services (replacing previous models of Fundholding and GP/Health
Authority commissioning) and the provision of General or Personal
Medical Services by GPs |
| The LMC has the right to be consulted about
the use of GMS resources by Health Authorities and PCTs |
| The LMC is responsible for ensuring that the
allocation of resources is equitable |
| LMCs wish to ensure that GPs commissioned to
provide traditional secondary care services are protected by being
‘approved’ and are properly recompensed |
GPs as professionals:
| Workforce planning, especially at a time of
workforce crisis |
| Education and training – undergraduate,
postgraduate and vocational training, continuing professional
development |
| Professionally-led regulation and
professional standards – ethical, conduct and performance,
including clinical governance |
| Liaison with consultant and hospital
colleagues |
| Collaboration with the General Medical
Council and consultation on its major proposals |
| Collaboration with allied professions –
local dentists and pharmacists |
| Collaboration with national professional
bodies – British Medical Association, Royal College of General
Practitioners |
| Occupational health issues, e.g. sick
doctors. The LMC must be consulted on and approve local
proposals for occupational health schemes for GPs and their
staff |
| Liaison with other professions allied to
medicine |
| National representation and
negotiation |
The LMC represents local GPs’ views nationally
through the professional representative mechanisms outlined below:
Local voices:
GPs can submit proposals to the LMC at any time,
but have a specific opportunity to do so at an annual open meeting
held by the LMC, normally in April.
In addition, proposals are distilled from debate
at the LMC over the course of the year for submission to the Annual
Conference of LMCs.
National voices:
The ‘parliament’ for GPs is the General
Practitioners Committee (GPC) which meets monthly throughout the year.
The GPC is the standing committee of the British
Medical Association with full authority to deal with all matters
affecting NHS GPs, whether or not they are BMA members. It is
recognised by the Department of Health as NHS GPs’ sole negotiating
body on GMS, and the GPC is attempting to extend this to PMS GPs.
Bedfordshire and Hertfordshire have two
spokespersons on the GPC to present our views and debate key issues.
Throughout the year, papers are produced by the
GPC for discussion at LMCs and from time to time the GPC consults all
GPs directly through surveys and questionnaires.
National debate and policy setting:
GPC representatives and LMC representatives meet
annually at the National Conference of LMCs. Proposals from individual
LMCs across the country are debated alongside those from the GPC.
The outcome of the debate determines the
framework for the profession’s negotiations at both national and
local levels.
National negotiation:
This takes place continually between the
Secretary of State and his/her team of negotiators and the profession’s
national negotiating team. The Secretary of State’s team is
supported by the senior civil service, the NHSE and the resources of
the NHS. The profession’s national negotiating team is elected
annually by members of the GPC, and is supported by other
professionals including public affairs and relations staff.
During 2001, the Government has delegated
responsibility for negotiations on the GP contract to the NHS
Confederation. The GPC is also responsible for the submission of
evidence to the Doctors’ and Dentists’ Review Body for pay and
expenses purposes.
| Local Representation |
The LMC consists of GPs elected on a PCT
constituency basis, and includes representation from GMS and PMS
GPs, non-principal GPs and GP registrars. In addition, members
are co-opted when appropriate; e.g. GPs with educational expertise.
The LMC meets regularly in full session and
between meeting in executive.
The LMC sends representatives to Health
Authority, PCT, regional office and other meetings where appropriate.
The LMC works closely with the other LMCs in
Eastern Region to ensure that GPs are represented at this level. We
now face becoming part of the Midlands Region, based at Leeds!
| Links with other bodies |
The LMC maintains an extensive network of formal
and informal contact on behalf of GPs with bodies such as:
| Local health authorities |
| The Regional NHS office |
| The NHS Executive |
| Other LMCs |
| Local Community Health Councils |
| General Practitioners Committee |
| Royal College of General Practitioners |
| Overseas Doctors Association |
| Small Practices Association |
| National Association of Primary Care |
| NHS Alliance |
| Members of Parliament |
| Local government |
| NHS Confederation (Associate member) |
| Helping individual GPs |
The LMC provides help and advice to assist GPs
steer through the NHS. Such help is available on all matters relevant
to general practice including:
| Workload issues and coping with change |
| GPs’ remuneration, incentive schemes,
Section 36 Local Development Schemes |
| GPs’ terms and conditions of service,
both GMS and PMS |
| Complaints, including accompanying GPs to
Independent Reviews |
| Premises |
| Partnership affairs, advice on new and
replacement partners |
| Employment matters |
| Any disputes which may occur between GPs
and the PCTs of which they are part |
| Sick doctors and those with performance
problems |
| Communications |
The LMC regards communication between
representatives and constituent GPs as essential, and is ever striving
to improve this. We have held Away Weekends to consider what being representative
means in the world of PCTs.
The LMC communicates with GPs in many ways
including:
| Newsletters - distributed to all GPs and
practice managers after LMC meetings |
| Website at www.bedshertslmcs.org.uk
containing news, guidance notes, media coverage, and more |
| Professional meetings/seminars, conferences
with key national speakers |
| Information bulletins on major issues and
summaries of national guidance |
| The medical press |
| Practice networking arrangements |
| Open meetings; surveys |
| Consultation with specific GPs |
| Telephone, email, fax and mail |
| Annual Report (also on our website) |
Modified from the original version by Middlesex
LMCs, with thanks
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