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Gold, incentives and meh

Focus on: GPs battle against spin

After the latest spate of negative press, GP leaders prepare to fight back by stepping up their PR operations

By Lilian Anekwe

After the latest spate of negative press, GP leaders prepare to fight back by stepping up their PR operations

It's not what you do that counts - it's how you look while you're doing it.

A lesson more familiar to politicians and PR consultants than jobbing GPs perhaps, but over the past year it's one the profession has been slowly, painfully forced to learn.

Now more than ever, the public image of the family doctor is under attack - with GPC leaders and ministers clashing regularly in TV studios and on the front pages of newspapers.

The most recent example: a survey by the Picker Institute for the Healthcare Commission, which found 74% of the 69,000 patients asked described themselves as ‘completely' satisfied with their GP's service.

Good news, on the face of it – but you wouldn't know it from the headlines the next day. The Daily Mail decried the wait for a GP as ‘still too long', while the normally measured Guardian attacked GPs for failing to give patients ‘prompt access'.

These headlines came after the finding that 25% of respondents had apparently been put off going to their GP because of inconvenient opening times. The figure in the latest survey had risen by four percentage points - from 21% in 2005. Is this evidence of a massive growth in demand for extended opening hours?

Dr Claude Seimon, a GP in Northolt, Middlesex, believes it's more likely to be a result of the barrage of headlines calling for evening and weekend appointments.

‘If you keep asking the same question over and over, eventually you will get the answer you are looking for,' he says. ‘It's like water torture – if you literally force the idea down patients' throats, they will give in and agree with you, just so you'll leave them alone.'

The bashing over access was only the latest in a long-running series of anti-GP stories, which appeared to be stimulated by the big increases in pay that followed implementation of the new contract.

Perhaps the most notorious ‘greedy GP' story came in October 2007, with the Daily Mail reporting on 300 ‘mega-bucks' GPs, each taking home more than £250,000 a year.

The GPC did its best to debunk claims of spiralling pay, but it has faced an uphill battle ever since to win the PR war.

As Dr Simon Parkinson, secretary of Worcestershire LMC, points out, once damaging claims are out there, it is very difficult to turn back the clock.

‘Once the seed is planted in the mind of a patient, it's always going to be there,' he says. ‘I don't think it's undermined the relationship I have with my patients, but clearly people have taken all of these pay stories on board and the public perception has changed.'

And there's no doubt in Dr Parkinson's mind what lies behind stories such as the Daily Mail's. ‘The Government has been phenomenally good at manipulating the media,' he says. ‘But I think it's got terribly personal and in the end no one wins.'

For many GPs, health minister Ben Bradshaw's recent broadside against the profession – claiming GPs operated ‘gentleman's agreements' not to open lists to new patients - was a personal slur too far.

Explaining why the Government had decided at last to axe the MPIG, Mr Bradshaw argued giving practices a correction factor ‘dampened the incentive' for GPs to take on new patients.

But Pulse reveals this week that the minister's smoking gun – the claim that he knew of a GP practice with only two registered patients – turned out to be a stunning example of stretching the truth. The practice to which he was referring – now with just one registered patient – is actually the Burrswood hospital in Kent, which in fact treats hundreds of patients as temporary residents every year.

It's also worth scrutinising Mr Bradshaw's assertion that his Parliamentary office had been ‘inundated' by emails from members of the public complaining they were unable to see a GP. Under sustained cross-questioning by Jonathan Dimbleby, on Radio 4's Any Questions, Mr Bradshaw eventually conceded that he had received ‘more than 10' emails.

‘Which I can tell you is a lot,' he added – a large enough number ‘to indicate to me that the claim… by the BMA leadership that this never happens is not true.'

So if a handful of emails were enough to prompt minsters to go ahead with a shake-up of GP funding, surely the 1.2 million signatures collected during the BMA's Save Our Surgeries campaign would be enough to force a rethink over polyclinics?

Unfortunately, the GPC's best laid plans - to generate maximum publicity by delivering their petition to Downing Street in a carefully-arranged press photocall - were overtaken by events elsewhere.

‘The coverage was less than we would have liked, because David Davis resigned on the same day,' laments new GPC negotiator Dr Beth McCarron-Nash, who led the BMA's Support Your Surgery campaign.

While the campaign did still receive significant coverage, the launch was another stark reminder of how limited the BMA's influence on the pages of the national press.

Last October, the GPC's nationwide survey of GP morale found that half of the profession was suffering from low or very low morale, and one in six were considering quitting. But despite a well-attended press conference, the story garnered little interest the following day from a national press apparently uninterested in communicating GPs' problems to the masses.

Similarly, the ballot of GPs over the contract offer in February attracted little sympathy. An overwhelming 97% said they had no confidence in the Government's handling of the NHS. But that wasn't the story: ‘Doctors cave in to Government demands' was.

Dr Parkinson thinks it is high time GPs fought fire with fire. ‘I think as a profession general practice needs to be equally, if not more, savvy at PR than the Department of Health', he says.

Dr Seimon agrees. ‘Thankfully the patients are on our side, and while they still are I would appeal to my GPC colleagues to get a professional PR agency and negotiators to represent us – because if there are just a few GP representatives fighting for us against extremely intelligent politicians and civil servants, we don't stand a chance.'

That may be a tall order, as the £300,000 spent on the BMA's campaign is dwarfed by the £77m spent annually by the Department of Health on advertising, marketing and communications.

But even if GPs can't go toe-to-toe with the might of the bureaucratic machine behind the DH press office, Dr McCarron-Nash says, there's still plenty they can do.

‘All GPs need to be media savvy. We can't control the media, but GPs can take back some of the control by using their own local papers. The media is much more respected and listened to by patients locally than it is nationally. So communicating with local papers is much more effective and will have a bigger impact with patients.'

Christine Mundin, who took over as the new head of press and PR at the BMA last month, insists the BMA will continue to doggedly fight GPs' corner through high-profile publicity campaigns.

‘The BMA's Support Your Surgery campaign has certainly hit the right note with patients and further activity is planned over the coming months,' she says.

‘Keeping the medical profession in the positive spotlight means promoting the value of the medical profession at every opportunity and rest assured that when negative headlines do appear we will not let them go unchallenged.'

It's perhaps a measure of the BMA campaign's success that PCTs are now wising up to the importance of effective communications. Hartlepool, Middlesbrough, North Tees and Redcar and Cleveland PCTs took out a series of local newspaper ads hitting back at the BMA's claims that surgeries will have to close so that GP-led health centres can open in their place.

And PCTs across the country are also set for an image overhaul. The Department of Health has ordered each trust to undergo a rebranding exercise to incorporate the word NHS into their title at an estimated cost of £15,000 each – a total cost of nearly £2.3m.

All of which suggests it only a matter of time before general practice gets a rebranding of its own.

Meanwhile, the battle to shape the future of primary care is likely to be won not in the surgery or the committee room, but across the pages of the national media.

The Department of Health

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