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An allergic manifesto reaction

Our blogger, Dr Peter Weaving wonders if he's gone native after reading the Pulse election manifesto and realising he disagrees with most of the views in it

Our blogger, Dr Peter Weaving wonders if he's gone native after reading the Pulse election manifesto and realising he disagrees with most of the views in it


Now it's not really my turf but I'm going to stray out of Practical Commissioning territory and set foot on the mother ship, Pulse, or more specifically her Manifesto for General Practice. This document is the distillation of the views of 900 GPs. So why does it provoke in me an allergic reaction? Have I been on the dark side too long and become irrevocably turned by frequent contact with both managers and patient representatives? Let's go through it.

1. Scrap patient survey pay targets.

Absolutely agree; we'll move at once to the Kaiser Permanente approach of fortnightly post-consultation patient questionnaires and compulsory attitudinal training for under-performing docs.

2. Cut waste on Darzi contracts, managers and consultants

The managers I know work as hard as we do, for a lot less money, and have a passionate support for the NHS and us clinicians, that we should reciprocate. We spend proportionately little on management and the evidence would suggest that we would be more cost-effective if we spent a little extra. But I would say that wouldn't I?

3. Stop fragmenting primary care

The biggest fragmentation to primary care was when we gladly and willingly gave up out of hours care.

4. Preserve clinical autonomy

Believe me when I look at prescribing and referral data I know only too clearly that clinical autonomy is alive and well. Perhaps we could just add that GMC bit about one of the duties of a doctor being to 'make good use of the resources available to you.'

5. Put the brakes on the private sector

Come on, guys, remember that phrase 'independent contractor'? We are the private sector.

6. No new work without pay

Put your hand up if you gave money back to the PCT when the midwives took over routine antenatal care? Alternatively when your pay went up by 30% in 2005 did you take on a third more work?

7. Revise contract to support partnership

There's nothing to stop us taking on partners; it's just cheaper to take on doctors as assistants and associates. Is that what we're doing?

8. Make general practice more woman friendly

As a GP in a female dominated practice I find myself constitutionally unable to comment.

9. Make NICE relevant to GPs If you check the NICE website this month; of seven items of guidance published I would consider the ones on breast milk, smoking in school, low back pain and bunions to be general enough for me.

10. Support GPs on care homes

See 6.? Seriously, we are paid more for looking after the elderly and some of them will be in care homes. Again my mantra would be for management and organisation. One care home, one GP practice would be a start but that flies in the face of choice and just about every other darned patient manifesto item…

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