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At the heart of general practice since 1960

Clinging to the cliff edge

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In no particular order, here are some things that have happened in the past few weeks.

• We’ve banged our heads against a PC screen trying to figure out why, despite jumping through all the Avoiding Unplanned Admissions DES hoops, our 10 grand pat on the head is showing as a somewhat less bankable zero. Meanwhile, the ‘automatic’ CQRS flu data extraction failed – another £10,000 down the back of someone’s sofa. It is, of course, our job to sort all this out.

• At 1pm on my last day duty, someone from our local care home requested a visit for a patient with a cough. At 2pm someone else from the home requested a visit for a different patient with a cough. Repeat hourly until 6pm.

• We heard the outcome of our federation’s bid for pharmacists from the pilot the Government trumpeted would save us all. Our pitch was supported by local GPs, the CCG’s prescribing committee and the Local Pharmaceutical Committee, created a trailblazing job description and aimed to ease workload in an under-doctored area. So naturally, it failed.

• A letter arrived from the police firearms department requesting a report on a patient. It contained the phrase: ‘While we understand most GPs are unlikely to charge a fee for the provision of information…’ Yeah, why would I charge for a non-NHS service to cover my time, my reputation and my secretary’s efforts? Lawyers wouldn’t charge, would they? And it’s only about a man with a gun. What’s the worst that could happen?

• I had an email from a community nurse stating: ‘While we were visiting Mr X, he passed a type 1 stool. Please review.’ Yes, really.

Etcetera etcetera. You’ve had much the same, and probably worse. Because this is what general practice life is like nowadays – a soul-destroying pisstake.

The response of the more militant is, ‘strike’. After all, the juniors did, almost. But it’s not that simple. We don’t have a single issue to pin a strike on. Our malaise is all-encompassing. We are undervalued, unpaid, abused and generally fannied around with to the point that, frankly, the job is now a crock of shit.  A type 1 shit, at that.

The rational response isn’t to strike, it’s to walk away. And that’s what’s happening. Oh, didn’t I mention? The other significant event was the resignation of the senior partner in a practice just across the corridor. He’s had enough, and the ripple effect may turn into a tsunami. So you know those things you talk about but hope won’t happen? Grey pubic hairs, cancer, the disintegration of general practice as we know it? They’re happening – at least the GP bit is, because our hastily contacted LMC told us. 

We really are clinging to the cliff edge – the most literal of tipping points, as the Government must realise. Either it will accept that the post-2004 contract ‘penance’ should stop short of actually annihilating general practice, or the conspiracy theorists had it right when they said it’s what the politicians wanted all along.

So watch the hand when it’s offered. It may haul you back from the brink. But more likely, it’ll shove you right over.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield

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Readers' comments (18)

  • Outstanding as always Tony. The issue to stike on is that they're killing us - literally.

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  • It's high time to become more aggressive towards the pisstakers.

    Care home staff if for LA/CQC to deal with and then to report to you.

    A letter from the police will normally require a senior copper attending the surgery at my GP's convenience.

    Community nurse has someone in charge and GP's regularly have meetings with their managers.

    And don't get me started on hospital consultants and service level managers.

    Problem is that there are too many people who include the GP processes into their ways of earning a living and are noreally surprised when thee is a fightback.

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  • Dear Tony,
    In my book journalist and political observer of the year.
    Well done.
    See you in 2016.
    Regards
    Paul C

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  • Let go and enjoy the fall. I for one have invested in a parachute called fukit&locum.

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  • Why all the doom and gloom , I think we have another 3 months before total collapse.

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  • As always - nail on the head.

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  • If the health provision in the UK is privatised then (1) government will be powerless to control it and (2) we will be able to determine what we no longer do. I have said for several months that the NHS has irretrievably broken down and cannot be fixed (arguments run to several pages). So mass resignation by GPs would be a first step...

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  • My husband, whom I would like to point out is a mechanic by trade, has 'helpfully' suggested we could recruit vets (as in vetinary surgeons rather than retired servicemen) as he read somewhere that they can treat people if necessary and ours has been terrific thus far with the dog.
    My mother who is nearly eighty and a retired secretary offered to have a go too..she has been an avid reader of women's magazines and has become quite an authority on medical matters which she assures me her GP appreciates greatly.
    I can't believe Mr Hunt has left them off the list of awesome solutions this year but if anyone would like a spare pair of hands and a super innovative, possibly award winning project... mum's free on Wednesdays.

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  • I have to agree with the learned Stevens X 2.
    We are a FAILED CORNER SHOP profession. Why anybody wants to save this pile from Hunt, I have not the slightest idea.
    So save the CQC and GMC the trouble. Go before you are pushed.

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  • Why , Oh Why are we enduring this penance from Hunt ? This ordure from the Profs?
    have we no self respect?
    Please GPC, PLEASE, please ballot for resignation and call our bluff.

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder