Our History
When the National Insurance Bill was first introduced in 1911 no provision was made for general practitioners to participate in the administration of the new state health insurance scheme. But the British Medical Association was determined that the profession should have a voice in its day-to-day running. It therefore ensured that locally elected committees of general practitioners (local medical committees - "LMCs") were given statutory recognition in the 1911 National Insurance Act as the representative voice of the 'panel' doctors.
The 1911 Act required the Local Insurance Committee (the forerunner of the NHS Executive Council, the family practitioner committee, family health services authorities and latterly health authorities) to consult all general practitioners participating in the health insurance scheme on a wide range of matters via the LMC. After the LMCs had been set up, a national committee was established within the BMA to represent the interests of 'panel' doctors in negotiations with government. This national committee, the Insurance Acts Committee (the forerunner of the General Medical Services Committee - latterly the General Practitioners Committee "GPC"), was recognised by government as the authoritative voice of general practitioners.
It was not surprising that the Liberal government agreed to these arrangements for representing general practitioners. The success of the 1911 health insurance scheme depended on the willing co-operation of a large number of independent practitioners. The profession supported the introduction of a state medical scheme but was strongly opposed to a salaried service; it recognised that the loss of the independent contractor status would undermine the freedom of doctors to practice without state interference, and ultimately put patient care at risk. General practitioners feared that government would seek to direct them in their day-to-day treatment of patients. This commitment to the contractor status remains a guiding principle of the GPC. Indeed, had it not been for the tenacity of its forerunner - the National Insurance Acts Committee - on this crucial issue, general practitioners could have been drawn into a salaried service (as were their hospital colleagues in 1948). The well tested and proven value of the contract for service with the local insurance committees led to the preservation and extension of this type of contract when the NHS was established in 1948. The Local Insurance Committees - the original predecessors of the HAs - knew that this contract worked successfully and were active in ensuring that it was preserved in the new NHS structure.
The first known records of a local LMC are held by the Warwickshire LMC, and date back to the first meeting of the Warwickshire Panel Committee which was held at Leamington on 17 March 1914, this committee included Coventry general practitioners, and met at least on one occasion in Coventry. Dr I Orton was elected as the first Chairman, and Dr Arnold Morris as Secretary. On 26 May 1914, the Panel Committee decided that they would become the Local Medical Committee as well (representing both Panel and Non-Panel doctors). The Insurance Commssioners initially failed to recognise this arrangement, and in December 1914 required the Committee to send the proposal for the Panel Committee to be the LMC to all local Medical Practitioners. Recognition was finally agreed March 1915.
In 1914, the Secretary was paid £50 per annum, members were paid 5/- for each attendance, and the Committee was funded by a voluntary levy of 1/2d per panel patient.
Health Authorities (and Primary Care Organisations) are still required by statute to consult LMCs on many issues; detailed in the regulations governing the provision of NHS GMS, the terms of service for general practitioners and the statement of fees and allowances. The LMC also plays an important part in the complaints procedure and investigation of matters relating to professional conduct.