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Is it time to think more radically?

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We live in increasingly militant times. GPs are resisting pressure to intervene in otherwise healthy patients, and are rejecting NICE’s 10% risk threshold for statins. It is part of a turning of the tide on overmedicalisation at all levels of the NHS, or simply an illustration of how busy practices are. Either way, we’re starting to see a significant refusal to play ball.

Junior doctors are taking their fight over pay and conditions to the streets and – as I write – are set to be balloted on strike action. Pulse attended the march to Parliament last month and saw first-hand how angry junior doctors are.

Quite rightly, they are refusing to be bullied as the Government tries to bring in seven-day services on the cheap. As one junior doctor asked, how can it be right to ‘devalue the very staff that deliver frontline services’?

Similarly, GPs have suffered year-on-year funding cuts since 2005 and are still being asked to do more with less, leaving many practices fighting to stay open for their patients. There have been initiatives from the BMA, the RCGP and our own ‘Stop Practice Closures’ campaign to persuade the Government to act, but the message still doesn’t seem to be getting through.

The less said about health secretary Jeremy Hunt’s ‘new deal’ the better, and while last month’s announcement of a new voluntary GP contract from 2017 may be linked with more funding, it fails to deal with many of the real issues. Being forced to open seven days a week will only worsen the GP recruitment crisis, and getting rid of QOF funding while still asking practices to record the work is little short of ludicrous.

Anger at the Government spilled over at the recent Pulse Live meeting in Liverpool, where GPs debated resigning en masse. The feeling was that may be a step too far, but there was consensus that GP leaders need to be more militant and consider options such as ‘working to rule’ or non-cooperation with the CQC.

Mr Hunt, at least, has managed to unite the medical profession, but there is little sign he is serious about tackling the real problems his Government has made.

The Spending Review this autumn will be the litmus test. As hospital trusts report huge deficits, the temptation will once again be to use hard-won savings at CCG level to bail out secondary care to prevent negative headlines, rather than think creatively about how to ensure patients can be treated more effectively in the community.

This is the Government’s opportunity to ensure its promised £8bn NHS investment is front-loaded and targeted at primary care – the only way to ensure GP services are robust enough to take on additional capacity and prevent the NHS falling to its knees.

It will show if the Conservatives are serious about the NHS remaining a publicly funded service – but it will also be a watershed for GP leaders. Anything less than a serious injection of cash will raise major questions about the ‘softly softly’ approach they have taken to date and signal that a much more radical strategy is needed to get the Government to pay heed.

Nigel Praities is editor of Pulse

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Readers' comments (14)

  • Vinci Ho

    Revolution has started.
    Nigel, you are our Jon Snow in this media war(major spoiler, Jon Snow will resurrect in coming GOT!)

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  • Why keep begging the government? I trust patients to find the money to pay for their own care more than I trust government. Let patients put an nhs primary care voucher towards any practice they wish to register with, with each practice offering their own levels of top up payments and levels of service.
    That is the only way to draw in resources for the high quality, responsive service both patients and doctors want.

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  • @ 2.14 and Nigel

    Spot on!

    If the politicians aren't prepared to fund safe healthcare properly through direct taxation an alternative model (based on other countries who deliver better funded healthcare) should be proposed. The medical profession should be proposing this as its 'duty of candour'. We know that the politicians and senior people that have been running the NHS into the ground don't have a 'duty of candour' and aren't themselves regulated and appear indifferent to our and the NHS's plight.

    The medical profession should not be party to allowing patients to be treated in dangerously understaffed, under resourced and unsafe hospitals. Instead it must look to other models which fund healthcare better for the sake of patients and itself. And yes, countries such as France, Germany, Sweden, Denmark, Norway, Holland, Australia, Canada, New Zealand have co-payments and insurance and look after their most need and vulnerable better than our NHS.

    We need to look beyond the political psuedoreligious NHS rhetoric, get our collective heads out of the sand as a country and as a profession and realise the current NHS model is unsustainable and needs to change for the benefit of all especially the most needy in our society.

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  • HEAR HEAR ALL OF THE ABOVE.

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  • Really is now time for forceful non cooperation with a failing government and sos doing huge damage to patient care by their culpable maladministration
    No compromise with these evil fools any more
    Rejection of all nonsense

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  • I have been saying for some time that we need to strike, and it is only this that will make the weasel crawl back with 'an 11th hour' offer, as he said this morning on the BBC.

    I already have nothing to do with the rcgp given their lack of potency in managing this, but may well be tempted back to the BMA should they put their money where their mouth is and do what is right for us as a profession, before we all leave.

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  • Trillions were spent to rescue the banks . They were too big to fail. No resources are available to bail out the NHS because " Healthcare is just the tonic for the FTSE 100"-Garry White. Privatisation will be seen as the saviour with new (heavily disguised) PFI deals. The NHS is tottering on its last legs and the vultures are circling . The juniors strike is being orchestrated to throw the blame on doctors . Obvious really.

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  • It's long past time, actually Nigel. No one important has the cojones to be straight with the public. And so, like a half-swatted fly, we spin bewildered, down and down to a slow but inevitable oblivion.

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  • The NHS free at the point of delivery is in its final years. Co-payments are now being talked about approvingly in the right wing media- the softening up process has begun. Moaning isn't going to make any diffeence to ballooning unmeetable need that has to be restrained by fiscal measures. As much as I hate to say it the NHS as we know it is in its death throes.

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  • This is worth a read:

    http://www.telegraph.co.uk/news/health/11975958/Junior-doctors-are-victims-of-an-NHS-thats-broken-beyond-repair.html

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