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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)

  • 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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