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Our 2009 hall of fame (and shame)

From swine flu panic to a salaried GP rebellion, it’s been quite a year. Read our lighthearted look at 2009’s most memorable events and colourful characters in our Christmas awards - and then let us know who you think should be crowned Turkey of the Year in our poll at the bottom right.

By Pulse news desk

From swine flu panic to a salaried GP rebellion, it's been quite a year. Read our lighthearted look at 2009's most memorable events and colourful characters in our Christmas awards - and then let us know who you think should be crowned Turkey of the Year in our poll at the bottom right.


Dr Richard Fieldhouse won plaudits and enemies alike after spearheading one of the most dramatic political moves of the year by threatening that salaried GPs and locums would turn their backs on the BMA and join the Medical Practitioners' Union en masse. He pulled off the neat trick of first lambasting the BMA's ‘absurd' attempts to represent sessional GPs, and then somehow getting himself onto the GPC, where he was greeted with a combination of open arms and sharpened knives.


Baroness Young, chair of the Care Quality Commission, is a worthy winner of this one, having spent the year firing off one-liners like a regulatory Bette Davis. GPs got an early taste of what to expect when she pledged to ‘do a number' on the bottom 10% of NHS providers. Later she branded some GPs as ‘mad, bad and dangerous to know' and rubbed her hands at the prospect of conducting surprise spot checks, recalling how she had given one hospital boss ‘the worst day of his life'. So perhaps we should have expected her surprise resignation last week – reportedly after a row with health minister Andy Burnham over her ‘volatile and hot-headed' management style. Yet, a bit like Margaret Thatcher, there was something about her that we quite liked, and will miss.


There's always a chance that in the short delay between Pulse going to press and arriving on your doorstep, swine flu may have mutated into the devastatingly destructive killer the Government feared it to be. You may be reading this from a bunker, surrounded by empty streets.

But as things stand, it's a virus that has prompted enough emergency guidance to wipe out the rainforests, seen mountains of Tamiflu doled out by call handlers and triggered a multimillion-pound vaccine programme. Yet for most (albeit not all), it has fewer symptoms than the common cold.


A proposal to hand paediatric care to a new breed of ‘children's GPs' must be a contender – just read the outpouring of negative comment from GPs on But a truly maverick initiative is one that prompts not only condemnation but also ‘disbelief', and for that, plans to allow patients to use direct payments to pay for homeopathy have to win the prize. The proposal, under which patients will be able to buy a wide range of ‘non-traditional' services, was described as ‘completely irrational' by experts at a parliamentary inquiry into homeopathy and ‘confusing' by the GPC.


This goes to whoever it was in BMA chair Dr Hamish Meldrum's practice who had the bright idea of bidding for a polyclinic. The Bridlington practice, together with three others and a PCT provider arm, successfully won the contract for the GP-led health centre, although Dr Meldrum insisted he was not directly involved and would not profit from it. Still, for the chair of an organisation campaigning against the nationwide rollout of the centres, the episode was a touch embarrassing.


Lord Darzi gets this one, for bestriding the NHS at great expense only to find himself increasingly sidelined and underused, until there was no option but to leave the front line. Which of course is rather appropriate, given that his lasting memorial will be his world-leading GP-led health centres, which are springing up everywhere from multimillion-pound LIFT buildings in Doncaster to car parks in Suffolk. The centres are shiny, generously funded and want for nothing – except for registered patients, of course.


Erstwhile health secretary Alan Johnson is known for his diplomacy and easy charm, but something must have got lost in translation as he took to the task of smoothing things over with GPs. At the opening of a Darzi centre in Middlesbrough, he demonstrated an unusual perspective on the challenges of balancing access with continuity of care, declaring he 'couldn't care less' which GP he saw. A spokesperson insisted the comments had been made in ‘a jokey sort of manner'. But GPs didn't see the funny side, particularly since the remarks came not too long after his stinging attack on singlehanded practices, in which he claimed ‘some don't even reach 1948 standards'.


Alan Johnson gets an honourable mention here too, for using his political cunning to first engineer a global flu pandemic to get out of an interview with Pulse in April, and then get reshuffled to the home office to avoid the rescheduled date. Crafty. The winner, though, is from the opposite benches in the form of Conservative health spokesperson Mark Simmonds, for refusing a series of requests for interviews from this publication.

If the Tories win the general election, there will doubtless be some big changes in health. It's just a shame Mr Simmonds is too shy to tell us what they might be.


Was it the return of working-class scouser Andy Burnham to the Department of Health that steered the Government back to its NHS roots – or could it be the imminent prospect of a general election? The young minister and alleged aspirant Labour leader, whose beloved Everton could face relegation in the same month as his Government, has been busy back-pedalling on the introduction of private providers to the NHS. In September, he rewrote the Government's approach to competition in a stroke with a speech to the Kings Fund saying NHS providers would be ‘preferred' and must be given two chances to improve before looking to private alternatives.


Primary care tsar Dr David Colin Thomé is often derided as a GP-turned politician, but he gets this award for a moment when he veered gloriously off-message – describing practice-based commissioning as a ‘corpse not for resuscitation'. The speed of his retraction – he told our sister publication Practical Commissioning it was a rhetorical question rather than a statement – suggests his bosses at the DH may have invited him in for a friendly chat. Still, at least health minister Mike O'Brien could see the funny side, telling the National Association of Primary Care conference – to barely concealed mirth – that the death of PBC had been greatly exaggerated.


NHS Solihull takes this one, gaining pride of place in the packed hall of shame revealed by Pulse's recent investigation into spiralling PCT management costs. It's a time when the NHS is battening down the hatches faster than the Titanic, so how much is the good ship Solihull expecting to leak on management salaries this financial year – £5m, £10m, £15m? The PCT admitted it had no idea, or apparently any way of finding out. A dishonourable mention to NHS Surrey, which did have a projected figure for this year, but had no clue what the figures were for the previous two years, on the grounds it had changed payroll providers. Next stop Governor of the Bank of England, chaps.


NHS Camden, with its ability to attract Keep Our NHS Public campaigners like the badlands of Pakistan do Al Qaeda rebels, is a clear winner here. The PCT was already in trouble for awarding three local GP practices to US giant UnitedHealth, despite a bid by local GPs being rated higher for the services it offered, and for entering secret, un-minuted talks with a string of private providers including Virgin Healthcare. But it was its award of a contract for a GP-led health centre to Care UK in August this year that really got the campaigners' goat, resulting in a legal challenge that forced the trust back to the drawing board on its public consultation.

Additional awards...


They are former friends, colleagues at the University of Exeter and leading figures in the debate over use of complementary medicine in general practice. But Dr Michael Dixon, NHS Alliance chair and medical director of the Prince of Wales' Foundation for Integrated Health, and Professor Edzard Ernst, professor of complementary medicine at Exeter, are the years least successful exponents of peace and goodwill to all men. In February, Professor Ernst accusing the NHS Alliance of being little more than a ‘lobby group' for complementary therapies. Dr Dixon responded by urging the professor to ‘stop lobbing grenades and telling us how to do our job'.


We awarded this to NHS Camden a few weeks ago on our website… for its ever-so-slightly disingenuous media statement on its Darzi centre U-turn. In a landmark case with major implications for the legality of the national rollout, the PCT admitted it acted unlawfully by ‘making a decision to invest' in the centre without properly consulting the public. But its statement read: ‘With such strong support across the borough for a GP-led health centre, NHS Camden has decided to seek the views of local residents again.' So the proposal was so popular, the PCT is going to… ask patients one more time, just to make sure.


The British Association of Dermatologists was the main aggressor in a bitter row over the quality of GP minor surgery that led to the extraordinary step of NICE reissuing its guidance on skin cancer this year. Their stance that only specialists or GPSIs should be allowed to excise skin carcinomas put them at loggerheads with the BMA and the RCGP who said this was too restrictive. Pulse exclusively revealed in May that following a stormy meeting between the RCGP, BMA and BAD, NICE had agreed to a series of concessions. The GPC claimed they had forced NICE into a climb-down over its guidance, but the publication of the revised guideline in November prompted anger from dermatology GPs. The Primary Care Dermatology Society said its members were ‘spitting blood' over the guideline as NICE had gone back on an agreement to revise the definition of a ‘high-risk' carcinoma.


Dr Laurence Buckman was furious at this year's LMC conference when he heard rumours that Pulse may have posted comments about his tie on their website. This turned out not to be true, but we did want to give him an honourable mention in this category for his sartorial choices and, in particular, the vibrancy of his cartoon ties. But for being a splash of colour in an otherwise grey sea of older male negotiators, Dr Beth McCarron Nash is the clear winner in this category. She has brought energy as well as style in her first year on the GPC frontbench, while speaking seriously on issues such as the partner-salaried divide and PCT management spending.

Pulse Christmas Awards 2009

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