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Opportunistic AF screening by GPs under consideration

We need to be spin doctors

Who speaks for GPs? Well, a whole host of organisations come to mind. The BMA handles our negotiations with the Government. The NHS Confederation and the Royal College do education and training. The National Association of Primary Care and the NHS Alliance also do stuff (though exactly what is a bit harder to establish).

But are they doing any favours for the GP's image? The TV news recently reported that GP earnings had cleared the £100,000 per annum mark. My first patient the next day said: "I hear you're doing all right then, doc." Similarly, the newspapers have leapt on quality and outcome framework money as if we were earning cash illegally. Follow-up pieces in the press have detailed the sums received by practices through windfalls and bonuses.

I present these thoughts at a time when the White Paper consultation on the future of primary care is taking place. Try an online survey to see what is being proposed. On the other hand, don't bother. It's a safe bet to say that, among the Government wish list is extended opening, dual registration and more information on social care.

The NHS is at a crossroads. All the political money is on public sector reform and we as GPs are heading for the mincer. Private providers are knocking at the door, while the Government listening exercise is asking closed questions and undermining the core of practice existence.

GPs might well be financially secure at the moment, but a brave new business world could bring an unfamiliar, competitive and uneven playing field.

Strong media presence

GPs need to make their presence felt more strongly in the media. The general public are never going to understand the complexities of holistic and gatekeeper primary care unless we explain them. And do so with panache. Dual registration and walk-in access countrywide may appeal to patients and politicians, but it is unimaginable to see how this will work with budgets, quality and demand. We need to say this. What happens when a private company gets the local franchise to check all your diabetic patients? What happens when walk-in centres run into the complex cases we deal with daily?

We need some stories lauding the benefits of family medicine and life-saving diagnosis made by GPs. And we're the only ones who can put these stories about. We need to present the effects of cherry-picking low-risk cases on local resources, and drains to local talents by preferential contracts.

The RCGP needs to step to the plate and start working outside the comfort zone of devolved faculties, patient participation and ethical publications.

These may be worthy endeavours but we are not playing school softball. Private companies want to play hardball – with our income streams and increasingly our core existence. We need to present to the media the human face of effective primary healthcare. And we need to do it vigorously.

Dr Andy Jones is a GP in Stamford, Lincolnshire

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