Additional questions:
Dr Clare Gerada replies to the unanswered questions asked during the live webchat.
Question from Dr Kath Checkland:
Thanks for your reply, Clare, but I don't think what you say is actually relevant. I know that primary care across the world faces some similar problems to ours, but I think most coal face GPs in the UK will see the conference theme and just feel that the RCGP is in an ivory tower and is not engaged with the real problems they are facing. A conference that looked seriously at the evidence surrounding commissioning and competition could have a really powerful voice, and could attract great publicity - one about 'global primary care' will not have the same impact.
Response from Dr Clare Gerada:
Dear Kath, as well as being a UK College, the RCGP has an international perspective. Commissioning is currently an 'English' issue and the college's conference should be relevant to all its members. It is also the 60th anniversary of the college in 2012 and we want a conference theme that is truly inclusive of all our interests. The overall theme of the conference is always a broad 'umbrella' and we work to make sure that the actual format is flexible and able to incorporate the latest issues of concern to members which, of course, are difficult to predict so far in advance. I've no doubt there will be sessions around commissioning and many of the speakers including myself will pick up on these issues and any other topical issues come October.
Question from Dr Graham Atkinson:
I think we can all agree that provider reform is a necessity in order to rebalance the NHS. Do you agree that the best way to do this is through the clinical commissioning priorities and policies of CCGs, or do you think the NCB (slimmed down PCT Clusters) as the commissioner or more primary legislation to reduce the independence of FTs would be a better option?
Response from Dr Clare Gerada:
Dear Graham, GPs must be equipped with the financial resources, the freedom, and the competencies they need to reshape services and achieve improved healthcare outcomes for patients. As commissioners, it is their job to set the overall direction of travel and the budget, and decide what kind of services should be provided and where. It's then for providers to determine how best to deliver these services. GPs may need to look at new models of organising their practices, such as by federating – joining and collaborating across practices to share expertise and resources. This could be expanded to include working with our specialist and third sector colleagues to design joined up care that makes sense to our patients.
Question submitted in advance by Dr Mark McCartney:
I am concerned about revalidation. We are told by the GMC that it is being introduced next year, but agreement on how it is managed seems a long way off. Clearly the College has a role in terms of education and quality, but is there a danger of the scheme being too expensive and unmanageable, particularly if the costs are passed on to doctors? Should the College not be working closely with the BMA to create a simple, effective and cheap scheme, before adding any bells and whistles? How does the College feel about the costs of remediation for doctors who fail the system and are not able to work as a result of this?
Response from Dr Clare Gerada:
Dear Mark, while supportive of the idea of revalidation, the RCGP has been working hard to make it straight-forward and simple – yet effective. We have been working with the GMC, the other Colleges and the BMA. We believe that the current proposals are nearly fit for purpose and we will be working over the next year to get them finalised. In particular we will be supporting the BMA in its negotiations to get appropriate provision for remediation should it be required.
Question submitted in advance by Dr Ellen Wright:
How does Dr Gerada reconcile her public statements such as 'We must resist the encroachments of the market wherever it threatens our freedom to serve our patients and our communities'. And 'In times of austerity, we need to come together so that we can collaborate, cooperate and innovate…not compete against each other'; her stance against the NHS Bill and supporter of salaried GPs in her role as Chair of the College with also being in a for profit partnership running 15 practices and employing 100 GPs?
Response from Dr Clare Gerada:
Dear Ellen, as I said earlier on in the Q&A, I am here in my capacity as RCGP Chair, not to talk about my practice. As College Chair, I have always said that I am not against competition per se, where it adds value to patient care. I am against competition based on price and a race to the bottom - and my work and statements as Chair of College reflect that important distinction. What I will say about my other 'job' as a practising GP is that I am proud of my record in general practice, taking on and improving practices, in areas of severe deprivation that were not meeting the needs of their patients. I feel that, with my colleagues, I have been able to make such a difference to the quality of care that patients in those areas now receive.
