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At the heart of general practice since 1960

The election run-up catches GPs in uncertain mood

A glance at our survey results so far suggests real anger over an ailing NHS, but no single prescription for change

A glance at our survey results so far suggests real anger over an ailing NHS, but no single prescription for change



Trying to gauge the mood of the profession is tricky at the moment.

Judging from the responses to our general election survey, there is frustration, and in many cases anger, at the direction the NHS is taking.

Much of that anger is directed at the Labour Government, as you might expect as a tired administration limps towards an election after 13 years in power.

What there isn't is a single, overriding focus for the frustration – an extended hours to unite the profession in disgust. And neither are GPs joined in a single, standout solution for the current problems.

Almost as stark as the rejection of Labour is the underwhelming degree of enthusiasm for the Conservatives, even though – as Pulse's poll before Christmas showed – more than half of GPs are planning to vote for the opposition.

The main merit the Tories seem to have is not being Labour, rather than a set of policies that have GPs weak at the knees.

The Conservatives' enthusiasm for private firms won't delight the profession, and the prospect of being given back responsibility for out-of-hours has had a cool reception from the GPC.

We'll be analysing the survey responses in detail in a week or two, but I've been spending some time filtering through your free-text comments, and here is my impression of the mood of the profession so far:

- GPs are desperately sick of the over-regulation and micromanagement they suffer in the health service – of being told what to do, in tedious detail, and of feeling like they are unable to exercise their highly trained clinical judgment.

- Specifically, you are tired of the politicisation of the health service – of targets being set on the whim of Government ministers, and of feeling like general practice is a prop in a giant political game. There is quite a lot of enthusiasm for the idea of an independent NHS board.

- GPs look around them at an NHS that has seen record funding increases, and see waste – spiralling expenditure on manager salaries, consultants and bureaucratic structures, and shiny new Darzi and walk-in centres. It's a major source of anger.

- GPs are tired of feeling like they are expected to compete in a giant popularity contest. Being paid according to the whim of patient survey responses, and expected to compete for custom with the abolition of practice boundaries, go against what many feel being a GP is about. A popular GP is not always a good doctor, as many of you have been saying.

- But general practice is a profession not only uncomfortable with its regulation from above, but also to some extent uneasy with itself. Resentment continues to simmer beneath the surface between partners and salaried GPs. The BMA's working group has neutralised that issue for the time being, but it certainly hasn't gone away for good.

Those are my impressions of the main themes, but there is plenty else besides. Dislike of the QOF remains fairly common, and on the subjects of commissioning and the internal NHS market, there is vigorous debate, and disagreement, within the profession.

It's going to be an interesting period in the run-up to the election. I'd be very interested to hear your views (in the comment box below) about how it will, and should, pan out.

Richard Hoey, Pulse editor

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