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My predictions for GPs in 2018

Editor's blog

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I know this column is a hostage to fortune and by June I will have to pretend not to have written it. Luckily I am not a proud man, so here goes.


GPs will be forced to open their appointment books to NHS 111 (odds 4/5)

The health service is obsessed with improving the state of urgent care (with good reason considering what is happening at the moment) and GP practices are unlikely to escape having to open in-hours appointments up to direct booking by NHS 111. CCGs already have a target of 5% of calls, but expect some new money to sweeten the deal in the next GP contract and for uptake of appointments to vary hugely – until patients figure out it is the best shortcut around the usual two-week wait.


Health secretary Jeremy Hunt will survive yet another reshuffle (odds 30/100)

I may be (very shortly) proved wrong on this one as various reshuffle rumours are swirling, but I would put my money on Jeremy Hunt remaining as health secretary. The PM is likely to want to keep Mr Hunt's leadership ambitions in check and sacking him is not really an option, particularly as he is a recent convert to the Leave cause. No other minister has his experience in the Department of Health or is likely to want to take on the challenging NHS brief at the moment, so I expect him to stay exactly where he is.


The RCGP will dissociate itself from the GP Forward View (odds 5/1)

Don’t expect Professor Helen Stokes-Lampard to preside over a bonfire of Forward Views in Euston Square, but there will be a toughening of the language as the college reviews progress this year. The tone could harden further if figures continue to show significant falls in UK GP numbers.


Scottish GPs will vote through their new contract (odds 1/3)

It won’t be a complete shoo-in for the BMA, but I predict GPs will vote for a new contract, which takes them on a completely different road from their colleagues in the rest of the UK. I predict a margin of 65:35, with Highland and rural GPs likely to vote against a contract that they suspect – with some justification – is not designed with them in mind. I would also put money on Wales following the Scots’ part-nationalisation of general practice.


Babylon Health will be granted the first nationwide GP contract (odds 10/1)

Last year’s rollout of its ‘GP at Hand’ online GP service in London was greeted with dismay by some after it was revealed the NHS had agreed it was ‘less suitable’ for certain patients. But recruitment to its online GP practice is going pretty well and I predict that at some point it will bid to be licensed to register patients across the country. The private company has had millions from Google and raised $60m in funding last year, so it’s poised to go very big indeed in 2018.


NHS chief executive Simon Stevens will resign (even-stevens)

The impossible job of running the health service is obviously taking a toll on Mr Stevens and I predict he’ll throw in the towel this year. In 2017, he asked for £4bn from the chancellor but was fobbed off with less than half that. Then, reportedly, he was told he was ‘personally responsible’ for ensuring there is no NHS crisis this winter. I think he’ll stick it out until the summer, but expect an awkward announcement before Parliament breaks for the holidays.


A politician will suggest GPs are ‘best placed’ to do something ridiculous (not accepting bets)

Last year saw former Labour leader Harriet Harman say GPs should assess all over-75s’ fitness to drive. Expect similar in 2018.


Nigel Praities is editor of Pulse. You can follow him on Twitter @nigelpraities 

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Readers' comments (3)

  • Vinci Ho

    (1)Instead of being specific like you , I have a funny feeling some big , I mean massive , but totally unprecedented event will happen this year as far as NHS and general practice is concerned.
    (2)Stevens will announce an early date of exit as I always see a parallel to Mark Carney in Bank of England. But watch closely how he would behave after such announcement(shackles being broken then).
    (3)Scottish contract will be voted through(at narrower margin than your prediction) but there will be aftermath though.
    (4)There will be the first super/mega GP practice taken over by a big ,private company .
    (5) Out of hour GPs will all go on strike.

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  • LetsCutTheCrap

    How about this:
    In order to provide a virtual carrot to GPs in the face of recruiting Physician Associates, the GMC in its infinite wisdom will recommend merging the GP register into the Specialist Register.
    The carrot in this would be that the gatekeepers to the system will now be the Physician associates and Nurse practitioners.
    GPs can move one step up on the referral ladder and thereby be deemed to have less reason to nag the government to sort their nuts out.
    Also GPs may feel less inclined to worry about the increasing and unfair demand placed on the system if someone else has to face it first.

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  • Vinci Ho

    This first week of 2018 has already been proven to be eventful for us and NHS. More interestingly , the political demeanour of Agent Hunt and Auntie May was leaving ‘clues’ of what might happen this year:
    (1) Four days ago (3/1/2018) , the health secretary came out of the blue to apologise to the public as tens of thousands of non-urgent appointments e.g. hip replacement,had to be postponed due to extreme pressure in many acute trust hospitals. This threat of a potential Aussie flu(H3N2)epidemic played a part. Given the track record of Agent Hunt, one could be a bit surprised that he ditched the usual pre-written DoH script ,as this kind of incident did happen before. But that ‘script’ was not entirely thrown away into the bin. In fact , it was used almost immediately by the PM and she responded to the public with the usual , politically correct statement of how much more the government had already invested in NHS and NHS being well prepared for this potential crisis. Of course , we all reacted and labelled her as ‘out of touch’.
    Two days later , Auntie May changed her mind . The headline in The Guardian was ‘Theresa May changes tack to apologise for postponed operations’. Both non-urgent operations and outpatient clinics should be postponed until end of January to help acute trusts to cope. The apology was a reflection of what she said in a carnival funhouse mirror.
    (2) But here is the catch : How often do we see politicians openly apologising to people? If so , would you expect these ‘leaders’ of the state to deliver the same message at the same time? Agent Hunt is the SOS and Auntie May is the PM. The SOS actually overtook the PM to apologise first while the latter stood firm implying that the government did not do wrong. Fascinating.
    My conspiracy theory (I know some of you don’t like it) is this was an agent’s banana skin for Auntie May and indeed she had to switch to apology immediately two days later.
    (3) Perhaps , there is a wider implication here and it simply translates into the game called ‘Who is the next prime minister?’
    The political tectonic plates are moving towards each other and ready for an earthquake. Auntie May is standing right on top of them with no ‘wise men’ on her side . Thanks to the general election she personally called followed by resignations of her close aides and the thunderstorms of sexual harassment allegations in Westminster blowing away her First Secretary of State. The calamity of an everlasting cough with falling letters on the set behind her in last party conference was more than an omen from the divine power. Many said her days were numbered but yet she is still the PM today.
    The fact that you are still standing , though , does not mean the earthquake is not coming with numerous hyenas plotting and waiting behind you.
    (4)The far right camp within the Tory party is certainly trying to reposition itself in this new year. The evidence is emerging. Mojo Bojo’s brother appointed a new non-executive director on the board of the board of the Office for Students for universities. Guess what ? This was the headline on Mirror a few hours ago, ‘’Theresa May slams 'disasteful' tweets by Tory students tsar Toby Young after he 'posted sick sexual joke about starving children' ‘’. (You can Wikipedia who TY is if you are interested).
    And let’s call this new camp HYDRA (especially if you are fans of Captain America and Agent of S.H.E.L.D ). While Mojo Bojo is losing credibility due to the calamity associated with the imprisonment of the Iranian UK lady citizen in Iran, HYDRA has a potential , new leader for the whole party , Red Skull. Red Skull is anti-abortion , anti-(same sex marriage) and thought food-banks were ‘uplifting’.
    Being ‘betrayed’ by Donald Trump(recommend to read Joshua Green’s Devil’s Bargain and of course, the ‘fictional’ Fire and Fury from Michael Wolff) , Steve Bannon had to find a new patronage . He came to visit Red Skull in December last year(2017) to discuss ‘UK strategy’. Interesting, isn’t it.
    (5) What about our good Agent Hunt then? He was a ‘Remain’ in the EU referendum but he had stated recently that he was wrong to worry about the British economy after Brexit.
    He also said that the EU’s “disappointing” and “arrogant” behaviour since the referendum had turned him against the bloc. To those Brexiteers , he ticked at least one box and was certainly not one of those 15 ‘Brexit Mutineers’ (labelled by The Telegraph) which included Sarah Wollaston (she defected from Leave to Remain in 2016).
    And if your memory was good , our good Agent did briefly run for the leadership of his party , hence premiership, when his mate Lord Vader resigned as the PM.
    And if the free trade deal with EU did not materialise after the ongoing negotiations, UK would have to revert to WTO default arrangements. Any ‘good connection’ with all these big non-EU countries like US and China will be additional ‘merit’ for a PM. Well, Agent Hunt’s wife comes from China.

    As I have been reading a bit more on the world history in 20th century , there is a temptation to equate these political circumstances with the Weimar Republic between 1919-1933. I know this is only a temptation and clearly there are at least , several variables ,including financial situations , to prove me ‘wrong’ . The worrying aspect , however , is ever-changing nature of these variables.
    Furthermore , the far left ideology and demeanour(with its network organisation )from opposition also recalls the memory of the Third International(1919-1943). The opposition Chancellor admitted to be a fan of Marx-Leninism and Trotskyism.
    George Orwell was telling and descriptive when he wrote in 1941 ,’’The choice before human beings, is not, as a rule, between good and evil but between two evils.’’
    He probably never knew he could become a ‘prophet’ seventy odd years later as the prophecy could just repeat itself.
    For the sake of some optimism, I would quote Yuval Noah Harare in Homo Deus (instead of Charles Dickens’ opening in Tale of Two Cities):
    ‘’This is the best reason to learn history: not in order to predict the future, but to free yourself of the past and imagine alternative destinies. Of course this is not total freedom – we cannot avoid being shaped by the past. But some freedom is better than none.’’
    May the force be with us(Jedi) all this year.
    Watch the cabinet reshuffle tomorrow (8/1/2018) and UN-happy fox hunting.

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