Naming and shaming GPs won't improve the NHS
Using cancer diagnosis figures to beat GPs around the head is the latest in a long line of slurs that are causing real damage, says Dr Farah Jameel
I spent a whole weekend last month following Facebook, Twitter, Pulse and various news channels covering the story that GPs who continually fail to spot signs of cancer could be publicly ‘named and shamed’ under new proposals from health secretary Jeremy Hunt.
I switched between feeling complete astonishment that such a story was seeing light of day, and disbelief that anyone with half a brain could think this was a good idea.
Since the story broke, it has added to the anger a lot of us are feeling. Perhaps the Government’s ultimate reason for proposing this policy, alongside others like it, is that drip-feeding negative stories, unrealistic targets and utopian aspirations will create apathy among NHS doctors.
Each negative headline that appears leaves me in turmoil. Every new anti-NHS slur sits uncomfortably with me and my colleagues, causing anxiety, stress and considerable emotional upset. The ‘accused’ doctors are real people – resilient, but nonetheless just regular people. And we’ve had enough. We don’t choose medicine as a career option to spend our time misdiagnosing patients or missing cancers.
Perhaps ministers hope to drive us out in droves to greener pastures – and this has already begun. A major BMA survey revealed in March that six in 10 GPs are considering early retirement, with more than half saying their morale is either ‘low’ or ‘very low’.
It could also be that there is a wider agenda: to set targets so unrealistic and undeliverable that we fail, providing an excuse to sell off the NHS in large chunks to the highest bidder.
If there is a case to be made about missed diagnosis, then perhaps the Government should be thinking about ways to address this positively, for instance by ensuring doctors are better equipped. Adequate funding may see doctors practise with a more manageable caseload, not fire-fighting as they do now. A realistic caseload might mean doctors could spend their sessions finding the right balance between seeing patients and keeping themselves up to date with all the latest guidance. Medicine involves lifelong learning, but we are swamped at work, and we don’t even have time simply to sit down and process our thoughts.
Increased funding might mean better provision of clinics, shorter waiting times and better outcomes. But do we even have a case to answer about outcomes? The workforce crisis in general practice has indisputably arrived; we’re 8,000 GPs short, with recruitment falling steadily. It would be fair to argue that GPs’ rates of diagnosis are still good when set against the backdrop of a growing workload and a declining workforce.
The bottom line is this: to continue to do a good job we need adequate funding and resources.
We are here because, as campaigns by the BMA and RCGP have stated, ‘your GP cares’, and ‘we put patients first’. We are here because we believe in the NHS, a system that puts patients at its core.
It’s time for a culture change – a breath of fresh air. The Government has failed us, our patients, and the NHS. Mr Hunt must stop attacking health professionals, scaring patients, and demoralising NHS workers and service users.
To perform to our utmost we need to be part of a positive, nurturing, well-funded environment based on good clinical care and patient safety. Get that right and cancer diagnosis rates will improve.
Dr Farah Jameel is a locum GP in Surrey and Sussex