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CAMHS won't see you now

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)

  • The NHS is preventing me from being the best doctor I can be. It's a monopsony that harms patients and medical staff. For that reason I'd be happy for things to change.

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  • It has always been divide and rule. The profession is not united as there are so many conflicts of interest and personal prejudices at play. GP's are divided into partners who can't strike because they have to run their businesses and salaried who could but would only harm said businesses. Hospitals consultants have their private practice outside their NHS time so rely on the Junior Doctors to cover the work in the NHS. Those voted to represent doctors at the BMA are also split between primary and secondary care but not equally represented at board level. The lure of the gong keeps quiet many who would otherwise be more vocal. Until the profession learns to respect itself and its diversity of provision the political class will continually undermine and denigrate the profession. They will not value it because we do not.

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  • ‘Do you believe in the survival of the NHS over and above the survival of general practice?’
    ​... ​this is my answer: not that I loved the NHS less, but that I loved general practice more.’
    ​In the original, Brutus​ said that he didn't want to kill his friend Caesar​, but
    ​it had to be done for ​the good of Rome and the Romans.​

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  • @ June Greaves | Other healthcare professional 24 Sep 2016 10:22am
    "Surely, General Practice IS part of the NHS just like Nursing & ALL the healthcare professions."

    But it isn't. GPs are private, SMEs, which are contractors TO the NHS.

    What you're claiming is similar to suggesting that Big Pharma is part of our NHS - tho' the reverse may soon be the case.

    Dentists, high street opticians and pharmacists, almost all of the residential care and nursing home sector, not to mention the agencies making fat surpluses supplying nurses, are part of the profit based sector, not our N H Service.

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  • @Anonymous | GP registrar26 Sep 2016 10:06am
    The NHS is preventing me from being the best doctor I can be. It's a monopsony that harms patients and medical staff. For that reason I'd be happy for things to change.
    ---------------
    "While they are in the GP part of their training programme, GP specialty trainees (GP registrars) are typically employed by the practice directly."
    www.nhsemployers.org/
    -------------
    Have you lodged a complaint with your employer about this hinderance to your rise to excellence?
    If not, why not?
    If so, what was the response?
    What 'change/s' would you welcome?

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  • The government are pushing us to resign /strike . Then they can blame us for demise of the NHS and provide something better ( at turning a profit ). Let things fail . Don't bust a gut. Let the ordure fall on their heads where it surely belongs.

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