Health

GPs in England threaten industrial action over in-person appointments

GPs in England are threatening industrial action in protest at the government’s attempt to force them to see any patient who wants a face-to-face appointment.

The British Medical Association’s GPs committee voted unanimously to reject the plan by the health secretary, Sajid Javid, which included “naming and shaming” surgeries that see too few patients in person.

The doctors’ union has decided to hold a ballot on possible industrial action, which could result in family doctors at the 6,600 practices in England reducing the work they undertake.

“GPs have been left with no alternative but to take this action. All efforts to persuade the government to introduce a workable plan that will bring immediate and longer-term improvement for doctors and their patients have so far come to nought,” said Dr Richard Vautrey, the chair of the BMA’s GPs committee.

It is a dramatic escalation of GPs’ increasingly bitter war of words with ministers and comes as soaring Covid cases put increasing strain on the health service.

It could herald the first major clash between the medical profession and ministers since the year-long junior doctors’ dispute in England in 2015-16, which involved a series of walkouts by trainee medics.

GPs have been angered by Javid’s instruction last week that they should see many more patients in person, and a plan to publish monthly data showing what proportion of each surgery’s appointments occur in person or virtually. They are also frustrated by what they say is a lack of action to reduce their heavy workloads.

Family doctors are also furious at a separate plan to compel those who are paid at least £150,000 a year for NHS work to declare their earnings, announced in 2019 and starting next month. The BMA has said this could imperil family doctors’ safety because “forcing GPs to publish their earnings provides no benefit to patient care, yet will potentially increase acts of aggression towards GPs and will damage morale amongst the profession and only worsen practices’ ability to recruit and retain GPs.”

It is unclear how much of an impact industrial action by GPs would have on the care patients receive. But if family doctors vote to forge ahead, it could lead to GPs:

Declining to comply with Javid’s insistence that they see patients in person who request it.
Visiting care homes less often to check on residents’ health.
Undertaking fewer or less regular medication reviews of the drugs being taken by patients with a long-term health condition.
Refusing to issue Covid medical exemption certificates, which will allow people who remain unvaccinated to continue working in environments such as care homes because they have a medical reason not to have been jabbed against the disease.

The BMA sought to reassure patients by pledging that any changes to usual working patterns would not affect GPs’ involvement in the rollout of either winter flu jabs or Covid booster vaccines. However, the decision has prompted fears that patients could find it harder to see a GP at their surgery.

“This shows the government’s deliberately provocative plans to name and shame GPs has backfired,” said Daisy Cooper, the Liberal Democrats’ health spokesperson. “Sajid Javid must now dial down the rhetoric and get round the table with doctors and patient groups to find a way forward. It would be unforgivable if, as we enter a winter crisis, people are unable to access their local GP.”

The BMA and Royal College of GPs are deeply frustrated that Javid’s plan contained few of their proposed steps to help to reduce GPs’ “unsustainable” workloads.

They had asked him to suspend the Quality Outcomes Framework (QOF) under which surgeries are paid agreed sums for monitoring the health of people with conditions such as asthma and diabetes, saying it takes up too much time and that removing the QOF system in Scotland has not damaged patient care.

It is not certain that GPs will hold a ballot because the BMA’s ruling council has to approve that course of action. But Dr Chaand Nagpaul and Dr David Wrigley, the union’s chair and deputy chair of council, are appalled at Javid’s stance.

Nagpaul has insisted it is the lack of GPs in England – the number of full-time GPs has fallen by 1,800 since 2015 despite a rising population – that has limited rapid patient access, not family doctors’ willingness to see all those seeking a consultation.

Vautry said: “The ultimate outcome should be to end the current crisis in general practice, to properly support practices to manage their workload pressure, including safely getting through the backlog of care caused by the pandemic, and deliver a safe service to patients, allowing time to create an agreed long-term plan to make general practice sustainable for the future.”

A Department of Health and Social Care spokesman said: “We want patients to be able to see their GP promptly and in the way they choose. Our plan will improve access and drive up face to face appointments, it includes providing a further £250m to GPs in order to boost capacity.”

Health

Nurses reject NSIWC circular on allowances

Lagos nurses, midwives suspend 3-day warning strike

The National Association of Nigerian Nurses and Midwives, Federal Health Institutions (NANNM-FHI), has rejected a recent circular issued by the National Salaries, Income and Wages Commission (NSIWC).

The association called it unfair and dismissive of the role of nurses in federal health institutions.

The circular, No. SWC/S/04/S.218/III/646, dated June 27 and titled “Review of Allowances for Medical/Dental Officers in the Federal Public Service,” was criticised for excluding nurses from key allowance revisions.

Rising from an emergency National Executive Council (NEC) meeting on Thursday in Abuja, the association said the circular failed to recognise the important contributions of nurses, who account for between 60 and 70 per cent of the healthcare workforce.

NANNM-FHI President, Nurse Morakinyo-Olajide Rilwan, told journalists that the circular was issued without prior consultation with the association, in spite of its impact on a major segment of healthcare professionals.

He said the document did not address critical allowances due to nurses, including shift, uniform, specialist, call duty, and retention allowances.

“Nurses run intensive shifts, spending extended hours with patients and their relatives. Yet, our current shift allowance is just 8.5 per cent of our salary, despite a 2009 circular approving 30 per cent of basic salary,” Rilwan said.

He added that nurses are required to change uniforms multiple times daily due to the nature of their duties, stressing that uniform allowance should reflect this reality.

“Uniforms are essential, not optional. At a minimum, we need three uniforms a week,” he said.

Rilwan said the selective application of the specialist allowance was discriminatory and unfair to nurses with specialist qualifications.

He noted that nursing includes several specialist cadres who deserve equal treatment.

He called on the Federal Government to prioritise the retention of trained nurses, who are increasingly migrating abroad in search of better conditions

“Nigeria has the nurses, but we are losing them due to poor welfare and policy neglect,” he said.

Rilwan also urged the government to reconstitute the Governing Board of the Nursing and Midwifery Council of Nigeria, saying it had remained dormant for years.

He added that nurses must also be included in the boards of Federal Health Institutions, as they represent the largest workforce in the sector.

He expressed concern over the removal of nurse educators, especially those on grade levels 7 and 8, from clinical duties, in spite of their role in training student nurses.

“The same circular states that trainers should be paid. Yet, those training others are being sidelined,” he said.

The NANNM-FHI president further demanded internship placements for university-trained nurses to enable them to participate in the National Youth Service Corps (NYSC), recommending a centralised system to ensure uniformity and quality.

He also called for the creation of a Department of Nursing within the Federal Ministry of Health.

“While we have a Director of Nursing, there is no actual department. There should be directorates for training, statistics, and clinical practice within that framework,” he said.

Rilwan said the association was open to engagement and dialogue with the government and would allow time for an appropriate response.

However, he warned that failure to act could lead to industrial action.

Health

Lagos to begin mandatory health insurance enforcement for residents

The Lagos State Government has vowed to begin the enforcement of compulsory health insurance policy for residents.

A Thursday statement noted that the Permanent Secretary, Lagos State Health Management Agency, Dr Emmanuel Zamba, said the enforcement would begin in earnest in early 2026, in line with the Executive Order signed by Governor Babajide Sanwo-Olu in July 2025.

She made this known at the Ilera Eko Providers Forum held at the Lagos Sheraton Hotel, Ikeja, where key stakeholders across the health insurance value chain, including healthcare providers, health maintenance organisations, and technical partners, gathered to review progress and discuss future implementation strategies.

The order mandates that residents must show evidence of enrolment in a health insurance scheme before accessing public health services, excluding emergencies.

‘We want all residents to be aware and onboard before enforcement begins’, the permanent secretary said, urging residents to embrace the scheme as a financial protection tool.

‘We are finalising our emergency services programme to ensure that no Lagos resident is denied urgent care’.

‘People in emergencies must be treated without first presenting an insurance ID’, Zamba added.

To further strengthen identity management and prevent fraud, Zamba disclosed that LASHMA had partnered with the Lagos State Residents Registration Agency to roll out biometric card readers across health facilities.

‘This will eliminate impersonation and ensure only genuine enrollees benefit from the scheme’, she said.

He also highlighted the agency’s expansion into diagnostics, telemedicine, and virtual care initiatives designed to extend access to remote and underserved populations.

‘Even if there is no facility near you, you can dial a toll-free number or use our app for a live consultation with a doctor, 24/7.

‘We have also installed virtual booths in marketplaces to provide health education and consultation services on the go’ he explained.

The Ilera Eko Providers Forum, according to Zamba, is not just a platform for information dissemination but a critical feedback mechanism.

He announced that LASHMA would now host quarterly provider engagement meetings to receive and act on feedback from partners, with a view to improving the scheme’s responsiveness.

‘This is a partnership, and like all successful partnerships, it must be mutually beneficial. We are here to listen, dialogue, and find lasting solutions together’, he said.

The permanent secretary noted that the state currently has over 865 accredited providers, ranging from primary healthcare facilities to specialists in dental and eye care, as well as community pharmacies.

‘Healthcare providers are now the gatekeepers of our scheme’, Zamba said, adding: ‘We are training them not just to offer care but to enrol clients right at their facilities as part of our broader strategy to drive up enrolment figures’.

Zamba revealed that over 400 providers had so far been trained under the newly established Ilera Eko Academy, a platform aimed at equipping providers with the tools and knowledge to actively support enrollment and implementation efforts.

Health

Lagos state govt move to curb activities of unprofessional skincare producers

The Lagos State Government has announced plans to regulate and curb the activities of unqualified practitioners in aesthetic medicine,skincare.

The state Commissioner for Health, Professor Akin Abayomi, disclosed this while speaking at the 19th Annual General Meeting and Scientific Conference of Nigerian Association of Dermatologists (NAD).Travel packages

“We all know that there is an explosion in aesthetic dermatology around the world and it is not peculiar to Lagos.

“As a government, we are very concerned about this trend of unqualified people masquerading themselves as experts in aesthetic dermatology which focuses on skincare.

“These quacks administer a whole lot of treatment options that can be dangerous.

“And so, the regulatory arm of the ministry, Health Facility Monitoring and Accreditation Agency, is looking into this exploding phenomenal in Lagos.

“We want to work with NAD who are experts to define the limitations of these quacks and ensure they are under close scrutiny by government to ensure residents are not exposed to quackery,” he said