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Independents' Day

2008: The best and worst, the heroes and villains

Pulse casts an eye back over the year’s top news stories and reveals the doctors, politicians and organisations we think deserve a special mention in our Christmas 2008 awards

By The Pulse news team

Pulse casts an eye back over the year's top news stories and reveals the doctors, politicians and organisations we think deserve a special mention in our Christmas 2008 awards

Diplomatic initiative of the year

For lessons in how to make friends and influence people

The BMA wins this for the incendiary briefing document drawn up by negotiators at the height of the extended hours crisis. The plans set out an ‘end of the world' scenario that would have seen GPs resign from the NHS en masse.

Once the document became public, GPC leaders back-pedalled furiously, insisting the idea had never been contemplated. But the document spoke for itself, telling GPs ‘we may have to face the possibility of an exit strategy from the NHS entirely' and claiming ‘there are real advantages in the profession threatening to leave now'.

An honourable mention too for Alan Johnson. The health secretary has tended to play good cop with GPs, but his off-the-cuff remark that some singlehanded practices ‘don't even reach 1948 standards' prompted outrage, not least from GPC chair Dr Laurence Buckman – himself a singlehanded GP.

Master of the dark arts award

For achievement in the world of political spin

Lord Mandelson may only recently have returned to Government, but health minister Ben Bradshaw was evidently committed to keeping his memory alive. Mr Bradshaw claimed his department had been ‘inundated' by emails from patients disgruntled at ‘gentleman's agreements' preventing them from moving practice.

And what was the true number of emails received in the deluge? ‘More than 10', Mr Bradshaw later sheepishly admitted.

The thirst for power award

For the individual or organisation that wants it all

Sir Michael Rawlins, chair of NICE, may be charming and urbane, but his organisation has been ruthless in its ambition throughout 2008, brushing aside criticism to attain ever greater influence. Whether it is public health, the QOF, getting people back to work or spotting signs of child abuse, the institute now does it, and what's more, it's guidance is set to be compulsory to boot.

The Care Quality Commission hasn't even launched yet, but it deserves an honourable mention for setting out its intention to regulate all GPs – and for reserving the right to fine, prosecute or close down practices that don't adhere to its rules.

The diligence in the call of duty award

For going that extra mile

City and Hackney PCT take this award, for the thoroughness of its response to a Freedom of Information request about patient confidentiality breaches. So thorough, in fact, that it managed to commit a brand new confidentiality breach in the process, inadvertently naming patients whose records had been lost. The trust reported a total of seven incidents of lost data or confidentiality breaches – swiftly making that eight.

An honourable mention here for Kent, NHS Eastern and Coastal Kent PCT, which left local GPs shaken and not a little stirred after telling them they would be reported to MI5 as a ‘risk to national security' if they failed to sign up to new information governance standards.

Pantomime villain of the year

For the individual who has most got under GPs' skin

Lord Darzi wins this for turning his name into a term of abuse among GPs, despite being run close by fellow health minister Ben Bradshaw.

The Dark Lord of Denham has disappeared in a puff of smoke since publishing his admittedly widely commended review of the NHS in June, but the damage was done early on in the year, and his spectre still lingers over the rollout of GP-led health centres and Darzi practices.

The Daily Mail also deserves a mention, for excelling itself with the intensity of its vitriol throughout 2008 – claiming GPs ‘waste £100m' on commissioning, only focus on ‘patients who bring in bonuses' and are responsible for the deaths of ‘10,000 Britons every year' by missing cases of cancer.

The road to Damascus award

For the year's most dramatic change of tune

As the Small Practice Association, it helped lead the battle against imposition of polyclinics and lent strong support to Pulse's Save Our Surgeries campaign. Its chair, Dr Michael Taylor, had described local plans for GP franchises as ‘insane'. But after a name change, to the Family Doctor Association, Dr Taylor was soon ‘actively engaged' with the plans. One largely admiring trip to a German polyclinic later, and the organisation's conversion was complete.

Dr Laurence Buckman also deserves a mention for being open-minded enough to moderate his view. Earlier this year, he was warning that ‘a polyclinic where it is not needed produces a doughnut of death around the outside'. Last month, he urged GPs to ‘stop being apocalyptic' about Lord Darzi's plans.

Denial of the year

For sticking to the party line in the face of conflicting evidence

The Medicines and Healthcare Products Regulatory Agency gets this one for its angry response to Pulse's triple-sourced story that it was preparing to make trimethoprim the first mainstream antibiotic available without prescription. It wrote in insisting: ‘The facts are very clear: absolutely no decision has yet been made to make trimethoprim available OTC.'

It stuck to that line, even after the DH released minutes predating our story, stating: ‘A member reported he had attended the MHRA Expert Advisory Group meeting and it had concluded to recommend the reclassification of trimethoprim.'

Foot in the mouth award

For a consistently unfortunate choice of words

Lord Darzi is highly commended here for his Freudian slip reported on the BBC website: ‘We need to separate that fantastic relationship between a patient and a doctor.' We presume the good Lord meant ‘celebrate'.

But Tory shadow health secretary Andrew Lansley wins the prize, for first saying the recession could be good for us, and then dismissing the virtues of integrated care organisations at the National Association of Primary Care conference – to a room packed through with dedicated ICO enthusiasts. ‘He could have been better briefed,' said one source, tersely.

The peace and harmony award

For fellowship among humankind at this time of Christmas cheer

They took six years to come out and have been branded ‘completely unworkable'. NICE grabs its second award for its technology appraisals on osteoporosis, which sparked civil war among its clinical experts.

Professor Peter Littlejohn, the institute's clinical and public health director, claimed the appraisals would provide ‘consistent access to cost-effective treatments'. But its clinical advisers begged to differ, saying following the guidance would be ‘unethical' and would ‘not be good medicine'.

Esoteric, perhaps, but cardiovascular risk scoring merits an honourable mention as the subject of another of the year's most colourful rows.

Framingham versus QRISK is a debate that has been fought at NICE, in the pages of Pulse and all the way to the committee rooms of the Department of Health.

And five true champions of general practice in 2008

Dr Beth McCarron-Nash
The Devon GP (pictured) who spearheaded the BMA's Support Your Surgery campaign – collecting 1.2 million patient signatures in the process – and was then elected as the sole female GPC negotiator, and the youngest. One to watch.

Dr Andy Black
PEC member and clinical lead for Herefordshire PCT, who in October quit in disgust after the trust caved in to Government pressure to open a polyclinic. ‘I blame the DH for spinning a line about not imposing – and I blame the PCT for rolling over,' he said.

Dispensing Doctors Association
The organisation that mobilised rural patients, doctors and MPs to kick up the biggest stink possible over Government proposals that would bring 700 dispensing practices to the brink of closure – and all based from a farmhouse in north Yorkshire.

Dr Alun Cooper and Dr Sally Hope
GPs who challenged NICE, as NOGG developed workable guidance for the management of osteoporosis.

Professor Julia Hippisley-Cox and Dr Peter Brindle
For their vigorous campaign to use QRISK – based on UK general practice data – in the national vascular screening programme, ahead of the US-based Framingham score.

Lord Darzi - Pantomime villain of the year Lord Darzi - Pantomime villain of the year Ben Bradshaw: Master of the dark arts award Ben Bradshaw: Master of the dark arts award Pulse presents its 2008 'Oscars' to the heroes and villains of the year Pulse presents its 2008 'Oscars' to the heroes and villains of the year

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