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Independents' Day

'Honest debate' needed over NHS crisis, says Gerada

NHS chiefs have too much of an ‘emperor’s new clothes’ optimism and instead need to have an ‘honest debate’ about what is going wrong with the health service, former RCGP chair and NHS England advisor Professor Clare Gerada has said.

Professor Gerada who advises NHS England on its London primary care strategy said that although some CCGs are doing ‘really good stuff’, underneath the ‘optimistic talk’ was still a ‘demoralised workforce’, with general practice in crisis and hospitals failing to fill vacant posts.

And GPs could not be expected to ‘fund their own transformation’, she told Pulse, with her work with NHS England showing that the issue of GP premises and funding must be addressed if GPs are to cope with additional work being brought out of hospitals.

Speaking at the Commissioning Show in London on Thursday, Professor Gerada said that the Government needed to crack down on doctor-bashing stories in the press and policies designed to ‘name and shame’ such as NHS Choices, the Friends and Family test as well as the CQC inspection regime.

She also called for more investment in occupational health services, saying: ‘Our politicians have to be facing inwards to us, and supporting and protecting us.’

In response to an audience member who commented that they were ‘struggling to find the positivity in the changes that we’re going through at the moment’ Professor Gerada said: ‘It’s the emperor’s new clothes, these figures that I’ve quoted are all referenced: 25% of NHS staff feeling bullied, four times the rate in the normal state.’

‘And yet you’ve got people saying it’s all wonderful, it is not wonderful, the problem is we have to say it for the young [doctors] because we’re all used to holding ourselves up.’

‘We need to have an honest debate about what’s going wrong in the NHS today, for us, because all of you are feeling like naughty schoolchildren.’

‘You’re being told off daily about how bad you are. How can you get up in the morning, how can we get up? We get NHS Choices in our inbox and I delete it if it says negative because I cannot bear to see another negative comment.’

Professor Gerada explained to Pulse that the Government’s ambitions for the NHS could not be achieved without addressing the current ‘crisis’ in general practice.

She told Pulse: ‘With respect to the emperor’s new clothes and recent changes, I think some CCGs are doing really good stuff, but actually I think if you scratch away at a lot of the optimistic talk what you’re still seeing is a demoralised workforce - even hospitals are failing to fill their posts.’

‘So this is not just about general practice, but general practice is the crisis because it’s the front door of the NHS.’

She added: ‘We have to give GPs the headroom, my work in NHS London is saying that if we want GPs to change, we need to give them the physical space: premises, but also the head space to change. They should not be expected to fund their own transformation.’

Readers' comments (24)


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  • Vinci Ho

    Simple questions:
    Who are the people that have not been honest?
    Is being 'not honest' the same as 'telling lies'?
    I would like the little girl who was laughing at the emperor to answer these questions.

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  • After days like my work today- i just want it to be over! Either implode and its the end of the NHS or someone inject some significant funding asap! But this incessant dragging on is tortuous!

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  • I did a day as a locum today and totally loved it. Lovely staff who looked after me and appreciative patients who said thank you!
    The life of a partner in general practice has become utterly intolerable and I am grateful every day that I walked away.
    There is life after partnership, and it is much, much better.

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  • It's the workload, and persecution we suffer now every day. After 17 years in GP I am now officially going half time & increasing my work in the private sector. At 43 years old. Practices in 3 local leafy nice areas of Cheshire can't recruit I heard today. No wonder. Who fancies the 11 hour days I do every day now? On top of that you're a 'named GP'. What next, named and shamed?

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  • The NHS is a 20th century model trying to deliver 21st century healthcare. This is never going to work. Free at the point of delivery is an admirable model but we have an ageing population and rapidly escalating costs which the taxpayer is unable to bear. The NHS cannot buck the market so it's time to face facts, we need to bring in more funds. Since the country has proven it cannot or will not tax the rich, the consequence is that the middle classes will have to shoulder the load which means co-payments and a corporate delivery model. We should not fear this because it works for the rest of the planet and to be honest I think most of the public are smart enough to work this one out for themselves. Sadly trying to get a politician to have an honest debate is another matter.

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  • Politicians don't give a damn about general practice,as evidenced by the evasive answers given in Prime Ministers questions. Many Trusts are in deficit and this hurts them more. The Colleges and the BMA must wage a very political campaign as the general election gets nearer.

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  • David has a point about politicians not caring, unfortunately none of the parties care. Whichever way we vote the NHS is going to be shafted

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  • We're overplaying our hand with all this GP crisis talk.The public already consider us as lazy underqualified fat cats.It doesn't matter how much we rail and shout from the rooftops our pleas will just fall on deaf ears.There are some areas in the country (rural & inner cities) which traditionally have always had recruiting problems.That's nothing new.Consider the simple maths:Medicine remains the most popular subject at undergraduate level.There is only a finite capacity in secondary care.Ergo ,even allowing for a minuscule loss to emigration (usually temporary),there will always be a supply of young doctors for primary care.General practice is not going to die.It will survive just fine as it has always done so.

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  • 11.11
    There speaks a sessional/locum GP.

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