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CAMHS won't see you now

A simple manifesto to earn GPs’ vote at the next election

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A mere seven months before the general election, and in the midst of party conference season, it seems an opportune time to review the Government’s progress on the NHS.

The coalition agreement – forged by the Conservatives and the Liberal Democrats in the heady days after the 2010 election – makes interesting reading four years on.

The promise to ‘stop the top-down reorganisations of the NHS’ has been famously and comprehensively broken. But what of the other pledges?

The ‘greater involvement of independent and voluntary providers’ in the NHS? That can be ticked off with the controversial section 75 regulations. A ‘strengthened’ CQC? Oh, yes. Enabling GPs to commission services. A big tick for that one.

There will be complex arguments over whether health spending has, as promised, ‘increased in real terms’ each year, but I am not clever enough to decipher them. Pass.

A bonfire of the quangos? With the formation of NHS England you now have a quango you can see from space. So, no. Giving every patient the right to register with any GP they want? Er, not yet. Incentives for GPs in deprived areas? Dream on.

So at best, it is a mixed picture for ministers – but there is still time.

A Pulse survey shows that while half of GPs are so disillusioned with politicians that they do not trust any party to run the NHS, most remain undecided on how to vote next May.

So my challenge to Messrs Cameron and Clegg is this: have a read of your Rose Garden agreement again and perhaps focus on fulfilling just one pledge before May. I suggest the following: ‘Doctors and nurses need to be able to use their professional judgement about what is right for patients and we will support this by giving front-line staff more control of their working environment.’

A laudable aim that has been buried in mountains of over-prescriptive bureaucracy, the continual raising of patient expectations and the imposition of new regulations and contractual requirements.

So here is a three-point plan to achieve this by May (and I know you like those). Firstly, slim down all the CQC criteria to just one question: ‘Are you a risk to patients?’ and restrict inspections to practices identified by local GPs as below standard. While you are at it, scrap all those infantile ‘Ofsted’ ratings for practices – and the 17-page document on how to display them. They will not improve patient care.

Secondly, get rid of all requirements on GPs that are not proven to have a directly beneficial effect on health and simply give practices the attached resources to support their patients better. Take, for example, the unplanned admissions DES: the mountains of care plans take hours, leaving less time for actual patient care. GPs know which patients need special attention and all they need are the resources to give it to them.

Lastly, and most importantly, stop bashing GPs in the media and work with the profession. Your words have an effect, so stop harping on about how practices are failing patients while saying they should be open every day from dawn until dusk. This raises expectations far beyond what is desirable or affordable. Oh, and forget ‘naming and shaming’ GPs; it will have the opposite effect from what you intend.

Job done. Now watch the votes from GPs roll in.

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Readers' comments (10)

  • Una Coales. Retired NHS GP.

    Really impressed Nigel! Alas the Tory plan is to get rid of the NHS. IMGs, the backbone of the NHS have been targeted mercilessly. NHS GPs are being targeted relentlessly and NHS consultants are to come next.

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  • Vinci Ho

    I think people should be disgusted that these politicians are using the reputation of NHS and GPs as a medium to try winning votes in general election after all they had done to destroy them . I feel sorry to all those who participated in the opening ceremony of London Olympic Games for NHS. Surely , you guys have been sold and betrayed.
    On similar tone , I was not at all impressed when Nick Clegg appeared in Sky News this morning trying to jump the bandwagon to claim some the 'glory' of the pro democratic civil disobedience campaign coded' umbrella campaign ' right now in Hong Kong.

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  • Excellent - Nigel for PM

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  • Harry Longman

    This is right. Isn't it interesting that in the public view, year after year GPs are our most trusted profession? Politicians, as I remember, come a very long way down that table. But the politicians, elected by that same public, don't trust the GPs. Maybe they are jealous. Sadly, the expression of that mistrust in targets, points, inspection and regulation, is ruinous both for the profession and the NHS.

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  • Ivan Benett

    Five point manifesto:
    1. Fully National General Practice. Remove the independant contractor status. All GPs to be made salaried
    2. Clear career pathway to progress over time into specialist planned care areas if they want to while, retaining generalist core response to urgent need
    3. Flexibility of working hours
    4. Single General practice units covering about 50,000 population for urgent and planned care
    5. Universal consistent high quality care, with quality incentives for improvements.
    How popular will I be??

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  • LOL! You Ivan will be very popular with the political police! But "it" ie the plan would be a rampaging disaster with no continuity or autonomy. I think you struggle to extrapolate the end outcomes of your so called plan. I'm not sure if it's naivety, lack of foresight or a plain simple hatred of the partnership model. if it's the latter, I wonder how that came to be.

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  • None of the political parties have the guts to admit the NHS has become unaffordable and then suffer the indignity of being accused as the executioner of the so-called "free at the point of delivery" NHS in the future. (Especially with an election coming).
    As Aunt Betsy would say in David Copperfield : "Blind, blind, blind Trot."

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  • I don't understand why people like Ivan Benett (assuming he is serious) seem to be on a mission to destroy general practice. Those who want to work like that can just stay in hospital medicine and leave general practice to those who appreciate the difference.

    I think Nigel has the riight idea; politicians need to understand why GPs are struggling/emigrating/retiring etc and make the simple changes that would reverse the trend - and no, it's not about the money - rather than risking the loss of the whole service and a generation of experienced but disheartened GPs

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  • It seems clear to me that the British public have a choice.
    Ivan's large "units" of 50 000 patients with " flexible staff" which would run 12 hours a day but have zero continuity and mean people travelling further or smaller practices giving a personal service from a doctor you know, open fewer hours with an "on call" system for urgent problems.
    Why doesn't Ivan stand for parliament and allow the British ( well, English actually) public to vote on his ideas?
    If this is what the great british public want then fair enough, if not how dare they force it on everyone without any debate or vote?

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