To be or not to be
You might not know who I am and indeed , as an ordinary grass-root GP, my opinion only stands as one of the thousands amongst my honourable colleagues up and down our country during this most extraordinary ‘feedback’ exercise .
I am grateful for your sincerity to write this article on this platform at a crucial , critical moment of history of general practice in NHS .
What is absolutely crystal clear , right in front of us(and the country ) , is a serious GP retention and recruitment crisis and the consequences of allowing this to deteriorate are irrevocable. Question is , whether it is also unforgivable if the current government and its subordinates continue to misunderstand and undermine the genuine reasons why we have reached this hitherto situation .
The model of a tax-driven , publicly funded health service is understandably under scrutiny all the time . The argument of administrative costs to keep the system afloat could become an unnecessary burden as the level of bureaucracy becomes exorbitantly high . Perhaps , this is one of the reasons why the ideology of moving towards more privately-run models and service providers , is always alluring . I accept that the reality is so often somewhere between the two extremes of argument.
Then we , human beings , continue to fail in learning from history . The track record of recent government(s) and NHS England in preventing this crisis of GP retention and recruitment is evidently poor . Some might easily jump to the conclusion that it was the government and its associated authorities which had created this crisis . All in all , the story so far has substantially dented the trust of GPs in the government and hence , NHS England . Confucius said , ‘an authority will not stand without the trust of people ‘(民無信不立） in the book of Analects .
And , Publius Gornelius Tacitus (56-117 A.D.), a historian and a senator of the Roman Empire, said neither good nor bad policies would please the governed if the government is unwelcome, which was later called "Tacitus Trap" in political studies.
Trust only comes after credibility which is , in turn ,derived from the track record of an authority .
This brings back to the fundamental question ,’ What is the current level of trust between general practitioners in NHS and NHS England?’ And I would argue that it is politically naive to claim ‘good’ up to this point of time . We , GPs , are always on the receiving end and it is the obligation of NHS England to bridge the gap . The fashion this draft of PCN service specifications was released on 23/12/2019 and more essentially , its content have failed to slake this desperate quest to re-establish trust between us and NHS England .
While your predecessors had failed to convince us that they were the benevolent leaders governed by their moral compass , I am cautiously optimistic that you can potentially be the ‘record-breaker’ and help the government to fulfil promises .
I have re-published my comment (below this one)specifically for the service specifications and it was enclosed in my original personal feedback , in case you were too inundated by all the feedbacks .
Watching the unfolding of the story of this human crisis of Wuhan coronavirus right in China right now , I am further reinforced in my belief that 21st century politics can only survive with better transparency, honesty and humility.
An ordinary PCN clinical director