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At the heart of general practice since 1960

Et tu GPC?

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I’m not going to bang on about Brexit, but it serves as a useful example for those uncertain about the meaning of a benevolent dictatorship. Put quite simply, if the Government had not held a referendum on EU membership, we would continue to have a future within it. This concept can also be observed with more emotive subjects such as capital punishment. Various polls have suggested that the British public would bring back the death penalty, but it is our benevolent dictators who refuse to put this in the spotlight.

How can anyone decide what’s best for this heterogeneous group without asking them?

Why am I rambling on about things that have nothing to do with medicine, let alone general practice? Well, we’ve seen a fair amount of benevolent dictatorship exhibited by our own profession’s leaders recently.

Let’s start with the junior doctors fiasco. It was clear from the outset that the rank and file was completely opposed to the new contract. Following extensive negotiations, they rejected the spruced-up version, in spite of open support for it by their leadership. Now we have new leadership and a new round of industrial action, and the decision-making appears to be going back and forth without the masses being asked their opinion.

And I, too, feel I have not been asked my opinion by the GPC. In spite of an overwhelming vote to ballot on industrial action at the last LMCs Conference, the GPC decided ‘mother knows best’ and overturned the decision. You see, we are too naïve to understand the complexities of the legal framework surrounding trade disputes. We have to be gently guided into the right course of action while deciding whether to hand back our practice contracts to NHS England. Put another way, Rome is burning and we are being told to substitute our fire hydrants for buckets.

I would have more respect for the U-turn if a deadline had been established. For instance: ‘If general practice does not have a 12% share of the NHS budget by April 2017, every practice in the country will close its list.’ I’m sure there are many more imaginative consequences we could create, if only we were asked.

So what is the role of our leadership? Is it to push forward its own agenda? Is it to dictate to us what is best for the profession? Or is it to pay heed to the eyes and ears of general practice at grassroots level and fulfil the wishes of the majority?

We are a divided profession. Partners versus salaried. Owners versus tenants. Part time versus full time. Generation X versus generation Y. How can anyone decide what’s best for this heterogeneous group without asking them? And the big question we need to ask is: ‘Do you believe in the survival of the NHS over and above the survival of general practice?’

Personally, I am with Brutus on this one. ‘If there be any in this assembly, any dear friend of the NHS, to him I say that my love for the NHS was no less than his. If then that friend demand why I rose up against the NHS, this is my answer: not that I loved the NHS less, but that I loved general practice more.’

Dr Shaba Nabi is a GP trainer in Bristol

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Readers' comments (16)

  • Azeem Majeed

    Actually Shaba, Brexit has a lot to do with medicine and general practice. I spoke about this at a recent seminar.
    hhttp://www.slideshare.net/AzeemMajeed/brexit-what-impact-will-it-have-on-the-uks-nhs-and-universities

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  • "not that I loved the NHS less, but that I loved general practice AND MY FAMILY more."

    Yes.

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  • Hmm: Brexit,democracy? Doesn't do to let the proles have a bite does it? Perhaps only those living in north Islington should be allowed the vote.

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  • Dear Dr. Shabi,
    It was ever thus, it's all about tactics, whether it is the nursing profession or the teaching profession or even the Police, governments depend on our altruistic principles to divide, browbeat & take advantage of us so that we sometimes forget why we chose that career in the first place.
    Surely, General Practice IS part of the NHS just like Nursing & ALL the healthcare professions.
    I suggest we are ALL fighting for the NHS. A lot will depend on the Judge's decision next Wednesday, but whatever the decision we cannot fail to admire the courage, sincerity & integrity of the junior doctors of 'Justice 4 Health' who, with the support of the public, have risked everything,
    FOR THE NHS !

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  • Have to be a little bit suspicious about the GMC involvement in the junior docs withdrawal from their intended first week of withdrawal of labour.My own personal opinion is that they have been"got at" by our political masters-again!!! and were parachuted in at the seventh hour to threaten the juniors with GMC attention in the event of any patients suffering extra pain or harm on account of treatment/surgery and outpatient app cancellations.Only the other day it was announced that the 50 percent of health authorities in England who bothered to reply to media queries about cancellations that had nothing whatsoever to do with the junior docs had cancelled 44000 ops n one year due to lack of available beds due to bed cuts and failures to fund their flagship policy of care in the community.No great concern shown for prolongation of pain and suffering in patients there then!!!.As for the BMA/GPC and their motivations re junior docs and the current self evident melt down in general practice,something does not smell right in the state of Denmark.The less said about the efforts of our Royal College the better.!

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  • Vinci Ho

    (1)The fine between leadership and dictatorship is finer than one can imagine . The just completed Labour leadership contest shed some light.
    (2) War and confrontation is always the last resort but there is nothing called a quick , short war . I think the Americans should have learnt the lesson by now. I do think believe the JD's war is not going to finish no matter what result on next Wednesday will be.
    (3) To sustain a battle mode for a long time is not everybody's cup of tea and certainly there are a lot of 'external influences' through this path at every hideous corners . Taking one step backwards is not entirely sinister if one can then take two steps forward.

    Whether one is a war hawk or war dove , it is a question whether one can sustain the appetite of this long , tortuous and unpredictable battle and still believing in winning ........


    ''in this proud land we grew up strong
    we were wanted all along
    I was taught to fight, taught to win
    I never thought I could fail
    no fight left or so it seems
    I am a man whose dreams have all deserted
    I've changed my face, I've changed my name
    but no one wants you when you lose
    don't give up
    'cos you have friends
    don't give up
    you're not beaten yet
    don't give up
    I know you can make it good''
    Peter Gabriel and Kate Bush


    ''Well life has a funny way of sneaking up on you
    When you think everything's okay and everything's going right
    And life has a funny way of helping you out when
    You think everything's gone wrong and everything blows up in your face''
    Alanis Morissette
    And I do believe in 'irony' as every Butterfly Effect counts .............

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  • Never give up. The war isnt over until it's over. We are being run by giant corporations and massive government interests (much driven by the USA). TTIP should tell us that. But if we dont use what voice and influence we have then we allow them to walk all over us- and in the case of health care, all over our patients. There is some wisdom in exercising caution but leadership is there to help create strategy in the face of the enemy and provide vision for what we are fighting for. At the moment, I just see retreat...

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  • Yes,Rome is burning,and will continue to burn.until......until

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  • Am I alone in believing that the BMA is not fit for purpose. They signally failed to win for GPs, they failed even to support the Junior Doctors and now it is the turn of the Consultants to get pasted.

    This continued fracture of our profession serves neither GPs, Juniors or Consultants. The cowardice shown by the BMA leadership merely cements our profession's misery for the future.

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