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Gold, incentives and meh

Letter of the Week: Women GPs should tackle sexism themselves

‘Navigators' off-course

The RCGP's decision to abandon its belief that GPs are gatekeepers to the NHS, in favour of describing them as ‘navigators', does not, on the face of it, alter much.

Patients will not notice a change. Their ‘navigator' GP will be just as likely to give them a prescription or refer them to the local hospital as their ‘gatekeeper' GP was.

With typical disdain, GPC deputy chair Dr Laurence Buckman describes the RCGP's move as ‘semantic dancing'. What's in a name, he implies. Yet he also says the GPC is firmly sticking to its preference for ‘gatekeeper'.

It is right to do so. And the RCGP is wrong to cast the term adrift simply because of the Government's current obsession with patient choice and empowerment. The description is fundamental to how the profession sees itself.

Misguided decision

As an illustration of how misguided the RCGP's decision is, read the words of the Government's own leading GP. In October 2002, primary care tsar Dr David Colin-Thome said this about GPs' gatekeeper role:

‘...a doctor, by acting as a co-ordinator of care and a patient advocate, ensures that the NHS offers both a comprehensive and yet cost-effective service compared with most other health systems.

‘Long may this continue in a NHS that maintains its values of social justice. This, for many of us, despite the pressures, is the reason we are proud to be GPs.'

GPs' gatekeeper role is at the heart of the NHS. It is also at the core of who GPs are. They are gatekeepers, not navigators.

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