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Gold, incentives and meh

Disappointed in the 'new deal'? You are not the only one

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This was the moment that Jeremy Hunt could have shown himself to be a visionary health secretary.

A man that understood the huge challenge that faces the NHS and took a long-term view to ensure its sustainability.

A champion for the kind of personalised, high-quality care in the community that general practice in this country is famous for.

Unfortunately, the ‘new deal’ he has trumpeted as a turning point for general practice is little more than naked political calculation.

I don’t want to sound ‘reflex negative’. There are good things in there. The health secretary clearly gets that the profession is struggling under its current workload.

A £10m emergency support fund to support struggling practices, as called for by Pulse in our Stop Practice Closures campaign is great news. We have spent months highlighting this issue and this fund could give those under threat some breathing space to restructure and ensure they survive. Bravo.

A pledge that every city and most towns will see a ‘visible signs of improvement in primary care facilities’ under the £750m of premises investment promised before the election is a significant investment. A brave move.

The commitment to recruit 10,000 extra primary care staff – including 1,000 physician associates by 2020 - is welcome.

But this is not – in my opinion – anything approaching a ‘new deal’.

Mr Hunt said in his speech that this is just a ‘first step’, but there is scant evidence here that suggests he is really serious about tackling the deep-rooted problems facing general practice.

There is a promise to look at ‘red tape’, but putting NHS England in charge of that piece of work is almost laughable as they generate most of it in the first place.

A ‘national marketing campaign’ to extol the virtues of general practice to medical students is good, but there was very little on how they plan to encourage disillusioned, burnout GPs to stay on.

There was a commitment to ‘explore the idea’ of golden hellos to encourage GPs to work in areas of greatest need. But nothing on urgently addressing the progressive decline in funding crippling practices, or halting PMS reviews and the MPIG withdrawl.

Overall it is a small advance, when a big offer was needed. An opportunity lost. A defining moment lost in the fudge of soundbites and recycled political promises.

And don’t underestimate the health secretary. By presenting this as a ‘new deal’ to the profession, he is lining up his guns to say in a few months: ‘You have had your new deal, now hold up your end of the bargain. Stop complaining and get on with opening seven-days a week.’

He is cleverly manoeuvring the profession into a bind, and unfortunately, GP leaders appear to going along with it.

GPs must be strong and call out precisely what this is. A sticking plaster, when a long-term solution is really needed. Otherwise we could be in real trouble.

New deal? No deal.

Nigel Praities is editor of Pulse

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Readers' comments (44)

  • Maureen Baker needs to resign for her comments

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  • There not much new here is there? Premesis money was already announced, PAs are old hat and there seems to be little of substance to halt the decline in recruitment , growth in over-regulation or cuts to funding. As for a deal, all these directives seem to be imposed by one side. It's time GPs stood up to the government and took back control of their lives and careers.

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  • Maureen Baker needs to resign for her comments

    - Add me onto the vote

    - Can anyone apart from Pulse actually represent the frontline GPs

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  • second that - maureen baker you comments and lack of support towards our members prove it. RESIGN

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  • Maureen Baker needs to resign for her comments - Hear Hear.

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  • Please resign. Grassroots GP.

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  • Maureen Baker you should be ashamed of yourself. We need tough GP leaders not political sycophants.

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  • Useless RCGP as usual -I am still a member unfortunately of this hopeless self serving organisation- more rubbish from the ineffective RCGP leaders as expected

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  • The RCGP should commission a vote from its members of ' no confidence ' in the RCGP leaders (past or present in fact)

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  • Maureen Baker you DO NOT represent me

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  • I have no confidence in any of the RCGP leaders, recent past or present. Maureen Baker should resign over her comments today.

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  • Remember Graham Taylor as England manager in Qualifying matches for Euro 92 when we were rubbish and he was portrayed as a turnip?

    The same call goes out to Maureen Baker

    IN THE NAME OF GOD, GO!

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  • Chaand has been rewarded with a CBE by the Govt. Guess whose side he and the GPC are on ? I don't recall real union leaders like Bob Crow getting a gong for his genuine services to rail workers.

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  • There is a promise to look at ‘red tape’, but putting NHS England in charge of that piece of work is almost laughable as they generate most of it in the first place
    And others
    http://www.pulsetoday.co.uk/your-practice/qof/practices-to-be-given-scorecard-of-clinical-outcomes-in-further-scrutiny-drive/20010287.article

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  • Agree... I have no confidence whatsoever in Maureen Baker and think she should resign as she is not helping the profession and consistently helping to make things worse.

    The BMA is no better... and the game is up Chaand! Many GPs (but not all yet) now realise that the BMA is run by consultants primarily for their benefit. The GPC is there to pay lip service to the notion of GP representation when it in fact it has no power at all.

    GPs ,sadly, have no real representation beyond our LMC reps. It is game over and time to retire, locum or emigrate if you can.

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  • Absolutely stunned at the reponse of the RCGP's response to the so called new deal. It does nothing to sort the present day workload and recruitment crisis and gives us little hope for the future of primary care. I think the real life GPs will vote #GPNoDeal.....

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  • GP's should have considered Faust when they signed the old deal. Selling authority and autonomy rarely works out well.

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  • Jeremy Hunt - whose only remit is to wear then profession down into further submission and subordination by tghe government . Golden hullos and seven day pilot schemes have not worked . Where are the exra GPS going to come from ? Having worked in inner city Leicester for 28 years I was so fed up with the constant interference and bullying tactics by NHS England that it is no surprise why recruitemt into inner city is virtually next ti impossible . I was fortunate enough to retire at 55 na will NEVER return to the NHS . It is better to work abroad and have a far supweriort quality of work /life balance . Doesnt Hunt undertand this basic concept?!!

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  • Can any active member of the RCGP explain to me why you are still a member? OK, line their pockets for the monopoly trainee exam, but why oh why do you carry on paying for Maureen to spout such rubbish? Save your money and take your family away for the weekend. while you still can, lol

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  • RCGP = chocolate fireguard

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  • Baker should resign and I should find a better use of my money, RCGP doesn't represent me or my profession any more.

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  • Regrettably neither the BMA nor ŔCGP are capable of pioneering the changes we need and we should withdraw the mandate they claim to represent GP. The lack of principled leadership will aggravate the schism between the political rhetoric and the continued decay of primary care services.

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  • Any practice opening at the weekend is traitorous. It will be aslipery slope to end of OOH and its back to you mate like the good old days lol

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  • Heard Maureen Baker on radio responding to the 'new deal'. Hoping for a robust counter argument outlining the absurdity of the whole idea. Instead a wet and pathetic effort...but utterly predictable. I hope you read these comments and do the decent thing...stand aside and give someone else a go...you are way out of your depth.

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  • I too support the calls for Maureen Baker to resign, she does not represent me. Will someone please stand up for the silent majority and take on the govt. with a mass threat to resign within 3 months. The worst that could happen is we could end up locums and be paid for work that we do!

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  • i'm sorry but people voted for maureen so as i've said before the profession must be split from those who are happy with things or just like to vote in the status quo and those who are unhappy (pulse posters)

    nothing will change until we get leaders who are willing to stand up for grassroots drs and rock the boat rather than looking for honors.

    had the rcgp or gpc started an investigation into alternate models and the cost to the state /individuals of paying for private gps we would have got a proper deal but the bma/gpc/rcgp just roll over to be tickled by their masters.

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  • Unfortunately as a GP Trainer it is mandatory for me to be a member of the RCGP, but I agree with all of those above who are calling for Maureen Baker's resignation, as her comments are so far removed from the views of most grassroots GPs I know as to be laughable.

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  • Vinci Ho

    While I am not surprised of any single bit in this 'deal' from JH. The 'positivity' comes from the 'implications' of his messages rather than the so called promises:
    What really matters now is the next round when GPC and the government sit down to negotiate . GPC needs to 'grow up' to realise the strength and weakness of where it sits ,under this most extraordinary circumstances in the most extraordinary time of history .
    I do believe the politicians need us more than we need them and Tories will need to start thinking about their position in 5 years time for another general election . (You can call me arrogant and narcassitic!)

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  • Resign Maureen Baker , you have let down the whole profession .

    Clever move to give Chaand a CBE and sad that he accepted it . No GP will trust him now , unless he gives an appropriate response about unachievable and inappropriate 7 day working . Balloting the profession well overdue .

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  • Vinci Ho

    There are several fronts in this war:
    (1) Agent Hunt is going to switch on the propaganda media machinery to brainwash and preach the public , supported by all his disciples( you know who!). We need a battle of anti-spinning . Nigel , we appreciate and respect what you guys have done so far.
    (2) Chaand, forget about your CBE, it is 'show time' , go for his jugular . He is not invincible and neither is Darth Vader simply because they need 'something' from us:
    (3) If we to join together or so called confederate , we do that merely to protect all of us , especially the coming generations(yes, you may argue there will be none!), but NOT to expose ourselves to more abuse and bullying.
    I dreamed a dream:
    It may be we shall touch the Happy Isles,
    And see the great Achilles, whom we knew.
    Tho' much is taken, much abides; and tho'
    We are not now that strength which in old days
    Moved earth and heaven, that which we are, we are;
    One equal temper of heroic hearts,
    Made weak by time and fate, but strong in will
    To strive, to seek, to find, and not to yield.

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  • Vinci Ho

    Do you hear the people sing?
    Singing a song of angry men?
    It is the music of a people
    Who will not be slaves again!
    When the beating of your heart
    Echoes the beating of the drums
    There is a life about to start
    When tomorrow comes!

    Today I finally understand the true meaning of 'emotional resilience' and why somebody 'sincerely' demanded us to have training on it........

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  • The government seems to be missing the point. Put thy house in order for the current core GP hours and when that is done effectively then and only then look to extend the service to 7 days. If this fundamental fact is overlooked then the government is doomed to fail and more sadly so will General Practice. Of course what we must not all forget that this is all part of a government plot in league with the Daily Mail since about 2006. The country simply cannot afford to continue the NHS as free at point of access without every single member of the population paying about 75% of our income in tax - and none of us would want to do that would we? So lets make it impossible for General Practice to work by not giving them a pay rise for 10 years and unsustainable workload demands. That's a fantastic way to bring down General Practice and when it fails blame it on us "uncaring greedy" GP's. Nice one!

    So what would I do? Look at skill mix but acknowledge that nurse practitioners, physicians' assistants, pharmacists etc whilst taking considerable workload off GP's will still need some supervision from doctors so give us the time to do this. But most importantly look at limiting patient demand not the government driving patients into a frenzy that just because they can pop down to Tescos on a Sunday that the same applies to having their medication review checked at the weekend. The only realistic way of achieving this is to adopt a system like Australian Medicare (their NHS system) where patients pay at point of contact then reclaim through Medcare.

    http://www.humanservices.gov.au/customer/subjects/medicare-services

    This just makes patients think twice before going to the doctor but means they get the help they need when genuinely ill. Friends who are GP's in Oz are still enthused about General Practice and have an enviable work-life balance.

    So Jeremy Hunt and the Tories, man up, be brave make some radical changes to the NHS and really make a difference for the future. Or carry on with your current ideas and you won't be re-elected in 2020 and there won't be General Practice in 20 years.

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  • There is a growing call to register your protest by applying or a Certificate of Good Standing with the GMC to signal your intention to work overseas. Choose a country where you think it is better to work overseas. Apply online (no charge) and register for your CGS. In a few months a FOI will be called for. Lets see how many of us are dissaffected, and I hope many of those that do get one actually do move overseas. It could be your salvation to get out of the NHS and this evil heartless situation UK GPs now face.

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  • Politicians will push their lucks and will make politically motivated snapshot decisions. That's what they do and we should not be surprised. The issue here is our inability to stand up to them.

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  • It's over

    Just as una coales is saying £1.5 trillion national debt

    No industry. Socialist welfare state.

    Britain is finished. They don't have the money to pay you or invest properly in healthcare..............that's why pay is dropping workload is increasing and they're looking for cheaper options with PAs and nurse practitioners.....see what happened with teaching standards when they bought in teaching assistants, policing with community support officers and nursing with HCAs....

    The British think they can solve all their problems by throwing pennies at the public...... Standards are going to decline to 3rd world levels.... They spend pennies on healthcare whilst they bail out banks to the tune of trillions!!!!!!!!!!!!!!!!!

    For the sake of your children's futures, get out while you still can..........

    BRITAIN IS DONE FOLKS.............

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  • When in the last couple decades has the RCGP advanced the profession - did getting rid of JCPTGP for MRCGP improve things (I'm not saying that MRCGP itself a bad exam), what of the extra year training that seems to have been dropped as unrealistic ? Profession has been far too sycophantic for far too long, and that largely comes down to BMA and BMA-GPC. Long ago dropped subscription for RCGP, and would have done same for BMA except I wanted access to BMJ - but access to wider & free searching on PubMed http://www.ncbi.nlm.nih.gov/pubmed makes that questionable too.

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  • analysis ...

    profession split ->

    GP as public servant (a) vs. GP as independent professional (b)

    group (a) control bma / gpc & rcgp and will never abandon NHS, they would rather the profession die than the NHS falter.

    group (b) are the ones taking individual actions (retiring, emigrating, locum. private etc) and have given up on rcgp & bma/gpc.

    group (a) seeks to either get rid or cull group (b) so they can refashion primary care to their needs OR have total control of group (b) by fear, sidelining their views, or by keeping them divided.

    The only question is how many GPs are in group (b) and will their dissent unsettle group (a) agenda? only time will tell.

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  • Anonymous | 20 June 2015 7:29am

    good idea !

    i'm going to apply for my CGS

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  • I am going to apply for my CGS too - come on follow suit!

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  • This comment has been removed by the moderator.

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  • what's the link for CGS application having trouble finding

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  • GMC application for certificate of good standing. Just applied.

    http://www.gmc-uk.org/cgs_online/

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  • I appreciate you taking a strong editorial view on this thanks Nigel.

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  • For the entirety of my time as a GP which is now more than 30 years, we have been led by turnips and sychophants - people who have sucked up to the government and have never come even close to representing my views. That is why I am not a member of either the BMA or RCGP - the only way I could express my frustration at these dinosaur institutions was to withdraw my funding for them. What do we have to do to get a leadership that actually represents us?

    As for the "new deal" - it is even worth the ink used to print it. It will do nothing for General Practice - it is just a politician doing what they do best - using the rest of us to make a name for themselves.

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