Largely agree, though I see one potential weakness.
The career that many are choosing to work in is missing something crucial. For very good reasons they are looking to less than full time working; they are looking warily at partnership (biding their time); they are looking at what else a CCT in general practice offers. None of these are bad things.
However the workload outstrips what is on offer in terms of workforce. This means those already firefighting to keep stuff standing whilst changes can occur are taking a double hit of less choice and more demands.
So "someone" has to have it worse than "someone else" for an understaffed underdoctered primary care to accommodate the career these newer ex trainees wish to pursue.
I'd suggest Ghosttown by the specials... great record.
I wonder if that negativity could relate to horrific morale amongst a highly intelligent group of people well used to assessing complex social, psychological, economic, pathological situations and finding route causes/diagnosis/prognosis for them?
Hold on hold on, I get it... Its satire isn't it?
This is tongue in cheek
No problem giving my real name. You are of course right that there is no conspiracy. It is simply open Tory policy and opportunism.
There is no way that chopping pensions, reducing budgets and staffing, clustering into nice convenient sized chunks and aligning IT systems to mine information usable by private providers could in anyway be preparing general practice for larger providers to swoop in with APMS contracts.
There is no way that the NHS is becoming simply a brand under which large private providers are picking off what they see as the juicy profitable bits.
There is no way for example that these larger groupings could ever be changed to a cheaper to provide GP lead not delivered service... oh no. Nothing in the direction of travel suggests this at all.
As to how much access I have to insider info, probably a little bit less than you. As to how much you have, only you can answer that.
Everything is wonderful, everything is going fine, nothing to see here... everyone is happy... don't tell the juniors.
Fitness for purpose after it's been going a long time. Probably standard practice. But a headline that does not engender confidence in RCGP.
Any healthcare setting can miss a PE.
Access, Access, Access... The false god to enforce change. Outcome measures of patient satisfaction and access are all that matter.
Demand outstripped sustainable levels so long ago that trying to reign it in can only be done politically. There never has and never will be any political appetite to pursue this. The profession is unlikely to regain control of primary care because of...
1. The fact that too many GPs are too keen to please everyone.
2. The RCGP is too keen to support 1, and VTS training teaches a mindset set by RCGP.
This desire to please everyone is an admirable trait in a spaniel or a whore (to misquote Disraeli).
You have pockets... our CCG have banned them.
If the RCGP wishes to represent GPs, and according to their strategy statements they do, then the fact they are not a union doesn't matter. Unfortunately for us RCGP has decided to mission creep into representing GPs rather than stay with educational standards.
Given they are going to represent us to the media we owe it to ourselves to ensure we make representation to them as to what our views are.
Sadly when I've done this I've been told my views differ from their oh so precious member survey. I think the college has followed a policy of appeasement with the government for so long now that they are locked into it. And what has the appeasement achieved... empty political promises and GPFV as their only policy to save GP.
Of course it is possible that people score your writing quite poorly because they don't think it's very good. It is of course possible to be not very good independent of gender/age/having a CCT/being a fan of RCGP/having experience.
Good luck with your further writing and leadership.
I think your conflict of interest is worth focusing on a little. Like many trainees there is a focus on the college as it is the lifeblood of your training. It holds the key to your career aims. I myself was much more pro RCGP when I was a trainee. You also seem to have continued ambition to further your advance within the college (to each their own). This does clearly colour your opinion of the college.
Your time as a trainee has now almost ended and you will enter the workforce as an independent practitioner (less than full time wisely) in due course. I think you will be well aware that the importance of the college rapidly declines in relation to the nuts and bolts of actually surviving in GP world.
When the college is no longer your master you tend to be more critical of its role and hence its public face. Its PR if you like. Here the RCGP has consistently been prone to targeting it's own and our feet with firearms.
My note of caution would be that (as with all these establishments) they aim to create those in their own image, to further it's own existence and importance and (assumed) relevance. Its role is to train GPs essentially, its mission creep to other areas and its shockingly poor PR in doing so does it real harm.
Great idea. Let's train up an expensive workforce that is unable to undertake the independent work required to function as a useful practitioner in primary care...
And so the dominoes began to fall.
The NHS mortally wounded thrashes around trying to steady itself. Weakened by the countless wounds inflicted by Hunt's forces and betrayed by evil temptresses of ringfencing the proud warrior, no longer able to support itself, stumbles to its knees. Hot tears stream down blood stained cheeks.
Knowing it has lost the fight and feeling the life draining from it, the proud warrior prays for a quick and dignified end. It is the least it deserves.
Jeering voices fill its consciousness. It recognises those of Hunt's forces and can shut those out but cutting through more are the voices of those it has protected. Demanding more despite having been given everything it has to give.
The end is drawn out, the wounds inflicted simply a cruelty now. The anaesthesia of death though is slow to arrive and the pain lasts an eternity. When the end arrives the final words heard are, "and I want a prescription for paracetamol and some zoppies"
I think we must look on 2014 as a warning of the harm that can be done in 12 short months. There is no more money there is much more work coming, no amount of working clever bridges the looming gap. Policy continues to ignore evidence. 2015 should start with an assault from us on the politicians, that is the only thing that will fire my enthusiasm.
A science teacher places two five-litre measuring cylinders filled with pebbles on the desk in front of his students.
Pointing to the first cylinder, ‘Is this full?’, he asks the class. There are murmurs of yes and no and a few non-committal grunts. He takes a large beaker of gravel and tips it into the cylinder.
‘Is it full now?’ The students are quiet, sensing a trick question. He pulls out a beaker of sand and pours that into the top of the measuring cylinder.
‘How about now?’ he says. A few students nod.
He shakes his head and produces a beaker of water from under the bench.
‘There is still more space in this cylinder,’ he says, as he pours water into it.
Unexpectedly he then turns his attention to the second five-litre container from which he grabs a few handfuls of pebbles and proceeds to pile then on top of the first full cylinder until they fall onto the table top.
'See there is still more room,' he says with a worryingly smarmy but reassuring smile. The students are quite, sensing that Mr Junt was having another one of his 'moments'.
'See there is loads of room in here,' he says grabbing yet more handfuls of pebbles knocking over the second cylinder which rolls to the edge of the bench but some how avoids falling off. He thrusts his handfuls of pebbles down on top of the first cylinder with such force that the cylinder chips and a crack appears in it's side. Water and sand stars leaking from the crack. The lab assistant having noticed one of Mr Junt's 'moments' comes and guides him, still smiling into the prep room.
'Off you go kids,' said the lab assistant. Sensing a longer break before double counting the students file out quickly. Only one looks at the cylinders on the way out and notices they are labeled 'demand' and 'GP resource'.
Dr Dawlatly, I trust that you yourself are wipe clean and have a cleaning rota.
Excellent Blog. As a far finer speaker than me said we are furious not just angry. The expression of never pushing a loyal (wo)man until they no longer care really does apply here. General Practice has loyally kept the NHS going to be rewarded time and again with unfunded work and blatant pay cuts, open political hostility, media crucifixion, denigration undermining and misrepresentation. Anger doesn't do our feelings justice.