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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

Readers' comments (11)

  • Well said! I couldn't agree more.

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  • Great synopsis - send it to the Daily Mail and any other paper and see who is brave enough to publish it!

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  • Very good Farrah Jameel. Well said.

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  • You go girl! Summed up very well

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  • Well said. No point in us just grumbling here though, suggest others copy and paste and send to Daily Mail, Daily Telegraph and Department of Health...

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  • I am from, went to Uni and did GP training in UK. However I moved to Australia earlier in the year - I had been having doubts about my decision. Although working life is better and income is far greater I do miss family and friends.
    On reading this yesterday (on australiandoctor.com.au) I am 100% sure I made the correct decision. I will not be returning to UK until general practice changes for the better.
    If you don't like it - vote with your feet.

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  • John Glasspool

    I'd like someone at the DOH to define a "missed cancer diagnosis"- er... thank you, thought so.

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  • We have spent hours going through our referrals data. Some are higher than, some lower than ' average'. What a waste of hours of extremely highly qualified MRCPs,,MRCGP time. No point, no outcomes to these hours spent trying to reduce referrals,except it is dangerous to the profession where we are constrained from referring, on one hand, and referrals returned by an administrative lackey, and named and shamed for not referring quickly enough.
    We can never,ever get every diagnosis right first time.
    We are damned if we do refer and damned if we don't.
    I am glad that I have come to my end in the NHS which I love so much. I am in the US at the moment and understand the magic of the NHS , because do many people go bankrupt here when they fall ill.
    So, so sad that this is what is seen as a solution in the UK.
    There can be no more 20 billion pound savings in the NHS without severe damage to patient care

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  • Well said Farah. Another bit of Hunt ingenuidioty! My advice to my colleagues is just carry on being good doctors - refer and investigate when appropriate and with the best interests of the patient in mind and just ignore these ridiculous government imperatives.

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  • if only we could rely on colleagues to tackle underperformance .....what about the incompetent practice bully? but publicly naming is a step too far..why stop at cancer Jeremy?

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