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At the heart of general practice since 1960

OK Mr Hunt. We'll just carry on as normal then eh?

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Say what you like about Jeremy Hunt, but…no, in fact, that’s it. Say what you like about Jeremy Hunt. I fear that, after his latest utterance, he’ll probably deserve it. Just when you thought he’d barked his barkingest proposals, he comes up with another to trump all that have gone before.

Specifically, that older patients with complex health needs will be assigned a single ‘named clinician’ accountable for their care at all times when they are out of hospital. With me so far? Guess what comes next? That named clinician should be the GP.

This has triggered a fairly predictable venting of spleen from our profession, with the above news story prompting a record-level number of comments. And not many are saying: ‘Bravo Mr Hunt.’

I must confess, though, that the story elicited in me not so much a mouth-froth as a wry and slightly smug smile. Because only a few weeks ago I wrote a blog in which I pointed out that the current obsession with changing the GP role insults what we have been doing for the last few years.  

And this latest pronouncement from our Health Minister proves I was right – the job of the GP has been poorly understood and completely unappreciated. This new announcement is not, in fact, simply another Huntenable view. Just read the background blurb on vulnerable elderly people which prompted his utterance: ‘There should be someone in primary care who is responsible for ensuring that their care is co-ordinated and proactively managed’.  Amazing, innit? Because, as you and I know, it’s an exact statement of the situation as it already stands, and has done for years – and that ‘someone’ is the GP.

What does he think happens to these patients when they’re discharged from hospital? Who does he think gets called to sort out the medication mess they’ve been left in, arrange the nursing and social care that the hospital forgets to tee up, perform the myriad tasks the secondary care team should have done but decide to leave the GP to ‘chase up’, and take on the long term follow up because consultants no longer do that kind of thing?

What this goes to show is that Jeremy Hunt knows sod all about what GPs do. And that explains a lot.

Readers' comments (6)

  • Before you rest entirely on your laurels Dr C, I fear that that is not the end of the matter.......

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  • I think we should all wake up to the fact that this will only provoke further workforce crisis.
    All those who can afford to retire will do so when all these untenable workloads are dumped on GPs
    Those of the younger age group will move abroad where they will find possibly better work life balance(already know a few who are testing the waters and liking it)
    There is already a recruitment crisis seeing that there is more work and less and less money for the extra work.
    I think that the only thing that keeps the GPs going is the the trust and love from the patients.
    Difficult to say how long this goodwill will last given that we are already working round the clock not just at the surgery but continue to do so from laptops at home.
    I hope that Mr. Hunt is ready for all the private providers who are already in it for profits
    I wish I could afford private healthcare as I am watching the truly trusted giant (NHS) being eaten into bit by bit and am unsure what I shall be able to avail when it come to my own health?
    A truly worrying thought having paid all taxes and NI contributions all these years.

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  • I think what Mr Hunt means when he says that there should be a "Named GP" for looking after people in the community (it makes me laugh every time I read it, because that is exactly what we do anyway), he is looking for a whipping boy. Some one to blame if anything goes wrong. If the district nurses did not do their job, get the GP to take the blame and cut his/her funding or force him to retire, or initiate a GMC inquiry about it. Of course we are not going to blame these failures on cuts in funding and services are we!

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  • ..and let's not forget that this very same politician who is ultimately responsible for the NHS111 debacle,rather than being dismissed,will be getting a £10,000/year pay rise

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  • Let's not confuse our ongoing doctor-patient relationship and a legal responsibility for 24 hr care. They are very different. The first is about understanding, empathy and care and is motivated by a desire to ensure the best outcome for those we care for and care about. The second is a legal responsibility to formally deliver on what may well be unrealistic expectations - both from the "system" and from the patient. You are fundamentally changing the nature of the relationship and potentially moving the GP from the role of empathetic advisor to legally responsible provider. Empathy goes, authoritarian control arrives. If I am expected to take on this role and the associated responsibility the I would want the legally mandated authority to impose my decisions to minimise my liability. This does not sit well with society's - and my own - libertarianism. Clearly Mr Hunt has no clue as to the nature of the doctor-patient relationship or the idea of continuity of care which drives General Practice.

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  • So I have to work all day and then provide night cover for all these poor multimorbid patients, So I am up a few hours at night and then work all day and then I am up for a lot of hours as a lot of sick multimorbid folks, then I work all day.
    You think this silly, but lots of GPs have done this for years before the contract.
    It behoves us like junior doctors to define health and safety.
    How come one rule for one lot and another for another lot?

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder