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In full: Dr Arvind Madan's resignation statement

NHS England’s director of primary care, Dr Arvind Madan, has today resigned following comments made in an interview with Pulse. Here is his statement of resignation in full:

I am passionately committed to general practice and primary care in England. This is why I accepted a three year secondment from my GP practice to NHS England as Director of Primary Care and Deputy Medical Director.

That secondment comes to an end later this year, but it is clear to me that, sadly, I have lost the confidence of some of my colleagues, and I have therefore decided to resign my NHS England position.

As part of my attempts to challenge the negative views – and even conspiracy theories – held by a small but vocal minority in the profession I posted on an anonymous online forum used by GPs. It was never my intention to cause offence but rather to provoke a more balanced discussion about contentious issues acting as a devil’s advocate.

I wish to make it categorically clear that these comments are not a reflection of NHS England policy, and it is now clear to me that trying to move the debate on in this way is not compatible with my role as Director of Primary Care. Supporting general practice is too important an issue to allow it to be mired in unnecessary controversy.

I would like to apologise unreservedly to those who have been upset, particularly in smaller practices.

In my 23 year career as a frontline GP I have worked in practices of all sizes and have always believed that smaller practices serve a particularly crucial role. I know they work tirelessly, alongside all primary care colleagues, to serve their patients and perform a role that goes well beyond being their doctor. GPs in smaller practices serve a particularly vital role as a point of constancy in the lives of often very vulnerable patients. They know their patients intimately, see families through times of great difficulty, and often hold their communities together. They are also essential to ensuring general practice services reach every inner-city neighbourhood and rural community in England.

I also know that too many smaller practices are struggling, which is why I believe that working in collaboration with others in an integrated manner should form a key part of how we strengthen them and prevent practice closures.

The main focus of my work at NHS England has been to help design and deliver the General Practice Forward View. I remain convinced that, as it unfolds, it will form the foundation for transformation.

I am proud of what we achieved so far, and sorry that I am unable to help see it through. However, I have immense confidence in the inspirational individuals I have had the privilege to work with at NHS England, who are dedicated to supporting general practice, and wider primary care.

Readers' comments (17)

  • If one says one thing and believes another and likely promotes something altogether different elsewhere then getting ones ‘come upance’ is the outcome. I am sure Dr M will now use his energies to fight for larger practices including his own Hurley Group. Those that have expressed their desire to save small and medium practices now need to step up and DO something. It’s likely Dr M was expressing NHSE opinion as of course he was working for THEM not us. He’ll be replaced by someone of like mind so the battle continues!

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  • YOU ARE HERE:HOMEPARTNERS PRACTICE BUSINESS
    NHS England's top GP resigns following Pulse comments
    5 August 2018

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    The NHS England director of primary care Dr Arvind Madan has resigned following his interview with Pulse.

    Ha admitted that he had been posting provocative comments under the pseudonym ’Devil’s Advocate’ on the Pulse Today website.

    In a statement, he apologised to small practices following his interview in Pulse, where he suggested GPs should be ’pleased’ when small practices closed.

    The BMA has released a statement ’in response to the resignation of Dr Arvind Madan’.


    Dr Mark Sanford Wood, deputy chair of the BMA’s GP Committee, said that the BMA had written to NHS England ’raising concerns and demanding action’ earlier in the day.

    More to follow

    GPs should be ’pleased’ when small practices close, suggests NHS’s top GP
    Read: Dr Arvind Madan’s resignation in full
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    READERS' COMMENTS (1)
    Patrick McNally | Salaried GP05 Aug 2018 5:05pm

    Whatever you think about them, the GMC's guidance on use of publically accessible social media is very clear - if you say you are a doctor, you must identify yourself:

    "Anonymity
    17
    If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.

    Pulse may be " intended for healthcare professionals only" and require professional registration details, but we should still hold ourselves to the same standards here, as we would in a face to face professionals meeting. I wouldn't say anything here that I would be uncomfortable saying to a colleague.

    I wrote about this back in 2013, when the guidance was newly released:

    http://triptogenetica.blogspot.com/2013/03/doctors-nyms-social-media-good-medical.html

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  • Sorry that comment obviously copy pasted badly into the text box!


    Whatever you think about them, the GMC's guidance on use of publically accessible social media is very clear - if you say you are a doctor, you must identify yourself:

    "Anonymity
    17
    If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.

    Pulse may be " intended for healthcare professionals only" and require professional registration details, but we should still hold ourselves to the same standards here, as we would in a face to face professionals meeting. I wouldn't say anything here that I would be uncomfortable saying to a colleague.

    I wrote about this back in 2013, when the guidance was newly released:

    http://triptogenetica.blogspot.com/2013/03/doctors-nyms-social-media-good-medical.html

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  • Dr Madan. Will you report yourself to the GMC?
    An NHS doctor.

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  • At last honesty on the omnishambles that is current Primary Care Strategy. So we all now know NHS England want large organisations and are starving practices of premises and resources to force practices to merge and federate. Our CCG is honest- no 30,000 patients-no flowing of money- it is all held above practice level to ensure maximal destabilisation and inability to resource service delivery. Yet those local practices led by GPs retiring soon locally don't want to do this ( as what's in it for them?) and are holding the rest of us back and killing off our patients Primary Care Funding- maybe NHS England should take premises funding and seniority out of superannuation payments to highlight the sustainability of their own practices for new GPs but which will trigger a mass exodus of retirements.
    In any event, no one has consulted on this larger practice strategy with patients which is where is is DISHONEST. Young patients without chronic illnesses do want internet 24/7 services which aren't often best use of limited resources as they are not using pharmacies first but the elderly and sick don't want long distances to travel for care and value continuity. Choose your population and decide how best to use your resources on the wants of some or the needs of many.
    So lets have an honest and open debate NHS England with patients about the future of Primary Care being urban based with no family doctors and no continuity of care and then we can all get on with what we are being asked to do. Rather than this stressful and financially damaging strategy of doing it by default.
    The fragmentation of secondary and other services has led to huge burdens of administration for GPs as individuals trying to keep the show on the road. Our patients have to travel often over an hour to get secondary services without accessible public transport as a result of Medieval County Boundaries which are no longer fit for purpose- maybe NHS England think this will work for Primary Care too. Several times last week patients cancelled important appointments as they felt it was too hard to get there and then GPs left to rearrange to see if they had cancer or not. Meanwhile the midwives and health visitors (on other private provider contracts) couldn't see patients due to lack of staff so we did that too.
    Come on NHS England be honest with GPs and most importantly with patients.Time to consult openly and honestly unless you were hoping to just get this change past without patients being consulted on what they wanted or valued and without voting for it?

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  • Just type into google "Devil's advocate pulse today"

    all his posts come up

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  • Doctor McDoctor Face

    http://www.pulsetoday.co.uk/53828.publicprofile

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