Where now for the NAGP?

In the previous issue, our editorial sought to strike an optimistic note. The new deal for general practice promised an end to cuts associated with the FEMPI era. The optimism was evident at the IMO AGM, where the new deal was positively greeted. For the first time in a long while, the future looks bright for general practice.

The IMO’s AGM had just ended when the cracks within the NAGP turned into an earthquake. On Sunday 28 April, it was announced the entire NAGP council was resigning, along with its President Dr Maitiú Ó Tuathail. Governance issues were cited as the reason for the mass walkout. Since then, further revelations have been made about the state of the Association’s governance and finances. As it stands, the future of the NAGP is extremely uncertain.

The establishment of the NAGP occurred within a particular context. In 2012, details of the salary and pension package of the IMO’s long-serving CEO Mr George McNeice caused outrage among many members. Also, FEMPI legislation had recently been enacted, and GPs were starting to feel the financial pressure. These factors created the impetus for a fresh start and new direction. From this, the NAGP was born in 2013, rebranding the old Association of General Practitioners, which was set up in September 1987 by the late Dr Mary Grehan.

As the NAGP has been denied a seat at the negotiating table, it has largely been an organisation of protest. In a recent statement, the NAGP referred to the “cosy relationship” enjoyed between the IMO and the Department of Health. Talks between the latter have resulted in a deal involving the long-overdue FEMPI reversals and a chronic disease package.

The NAGP council’s chief frustration was not the relationship between the IMO and Department, however, but the internal governance of the Association. These governance concerns were first revealed in the Medical Independent (MI) last year.

 A governance report from Ampersand, which recommended a new structure for the organisation, has not been implemented, as MI recently reported.

“Subsequently, serious issues of internal governance were brought to the attention of the national council and the directors of the NAGP,” according to the statement from the council. 

“Significant efforts were made to resolve these issues through a process of renewal, transparency and accountability. We regret and apologise to our members that this was not achieved. As a result, the national council, whose role is advisory, have tendered their resignation to the directors.”

MI also revealed the financial problems affecting the Association. In January of this year, we ran a story showing how abridged financial statements for the NAGP revealed a liability of more than €114,000.

The deficit for the year ending 31 March 2018 represented a significant increase based on financial statements for the end of March 2017, which showed a deficit of €33,000.

In a recent memo to members, the NAGP stated it will continue to fight for general practice. And there are still plenty of things to fight for. A new contract is badly needed. The new deal has still to be ratified by IMO members, and then GPs individually. Concern exists about whether there is capacity in general practice for the chronic disease programme.

But for this fight to occur, medical representative bodies must be fit-for-purpose and have as strong a foundation as possible. Many GPs have put their faith in the Association, so it would be a great shame if this faith was for nothing. The IMO largely came through the crisis following the George McNeice controversy. It remains to be seen whether the NAGP can do the same.