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At the heart of general practice since 1960

Carving up the NHS

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I am full of admiration for my surgical colleagues. They work long and hard and perform wonders to help put the human body together again. The surgeons I knew and know were and are wizards with their hands, and they perform Herculean tasks to save lives. I have many patients who are walking about today who would be dead or maimed had it not been for the surgeons’ skills.

The oft-repeated adage that a surgeon is ‘a physician who can operate’ has always been wide of the mark. But surgery is glamorous: it is doing something active, and surgeons often deride other doctors with the taunt that all they can offer is ‘pills, promises and post-mortems’. Many young medical students want to do surgery because of this glamour.

Then, sometimes, surgeons stray into other fields of medicine. There are many examples of surgeons who have devoted their time after they have finished doing surgery to developing policy and giving advice - advice that has often been pretty catastrophic for the NHS and their colleagues.

Some examples of this phenomenon:

Liam Donaldson started training as a surgeon, and was an anatomy demonstrator (a frequent step to a surgical career) when I was a medical student.

He subsquently left surgery, went into public health and eventually became the Government’s Chief Medical Officer. He was responsible for advising the Government into restructuring the training of doctors, a system that has been widely acknowledged as to being utterly disastrous. He also presided at the time of the development of the Private Finance Initiative, and the enhancement of the purchaser-provider split. Finally, he oversaw the swine flu panic. Now knighted.

Bernard Ribiero used to be a surgeon who led the Royal College of Surgeons, and was an enthusiastic advocate of the Health and Social Care Bill, that is currently wreaking havoc with the NHS. He now sits as a peer representing the Conservative party.

Ara Darzi is an Armenian-born, Irish-trained, London-based specialist abdominal cancer surgeon who is rightly praised as an intelligent and innovative clinician. He was asked by Gordon Brown to advise the Government on reconfiguring the NHS and suggest ideas to help with this. He came up with an idea of polyclinics - a concept that was impossible and hopelessly ideological. These were pushed through against most people’s advice, and have proved to be ineffective and expensive. He has returned to the thing he is good at - surgery. Now in House of Lords.

Sir Bruce Keogh used to be a cardiac surgeon, and now sits in the Department of Health’s plush offices pontificating about how the NHS should be run.

His latest idea is to suggest that GP surgeries are open seven days a week. So that will be an extra two days, or an increase in opening times of 28%. Has he thought this one through yet, or is he flying a kite?  Will he be able to guarantee that there will be enough extra reception, nursing and secretarial staff to support the extra medical staff required? Where will the money for this idea come from, as it will be much more expensive?

These four surgeons have been active in the last ten plus years presiding over the descent of the NHS into chaos. They apply their surgical mentality to systems, without reflecting or measuring the consequences.

The Jobbing Doctor is a GP in a deprived urban area of England. You can follow him on Twitter @jobbingdoctor.

Readers' comments (12)

  • Heartily agree. Going by track records of those surgeons named I would say they least able to actually make any changes to NHS and those least able to actually have any understanding of what happens at coalface ie primary care!
    The latest idea to open GP surgeries 7 days a week -just like Tescos- is not only an insult to hard working GP's but also demonstrates complete lack of any knowledge about how GP operates. This is fine if extra financial resources and manpower available to man this 24/7 service but to expect current GP's and staff to take on this additional service is ludicrous. We already work very hard Mon-Friday (usually 10 hour day) and many GP's very stressed,burnt out and demoralised by the way being treated by this Gvt. How on earth can we retain any sanity and have some sort of 'normal' family life if this idea is also foisted upon us? More will retire early and the younger generation will look to other countries as quite frankly GP is being used and abused by all and sundry and only so much can actually take before cracks

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  • If Bruce Keogh really wants to operate General Practice like Tesco's then he should study the business model. They pay their top managers well so that they get the best people. They incentivise them to bolster morale and increase productivity. They foster a working environment that encourages teamwork and brings out the best in all their workers.
    If you treated GP's and their staff in this way you would restore some goodwill and GP's could once again start doing wonderful things with the resources before them. If you treat them like they live in your workhouse then your returns will steadily deteriorate.

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  • I have many staff of a local Tesco hypermarket as patients.

    Based on my experience of helping them with work related issues I suspect that Tesco may treat their managers and executives well but not the 'lower ranks'.

    Now, if the GP can be seen as a 'lower rank',then yes I agree that Tesco treat their staff like the NHS treats GP's.

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  • Sounds a bit like putting Bruce Forsyth in charge of the BBC. I'm sure he'd have a lot of good ideas, but would he understand and be able to manage all the elements it takes to produce the final product?

    And don't we him to put all his efforts into performing rather than being behind the camera? Especially if we've paid both for his tap dance classes and for a ticket to the show?

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  • Mark Struthers

    I suspect Tescos are crap employers as much as some GP partnerships are sh*tty employers.

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  • Well most of the above are Non-operating surgeons - If there was ever an oxymoron this is one.
    On reflection I `ll remove the prefix "oxy" from my previous line!

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  • Perhaps surgery could be run on the Tesco model. We could dispense with surgeons. Patients could do their own operations before queuing for ages at the checkout.

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  • What a fabulous idea! Self service surgery 'just like Tescos' ..I love it!

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  • Great Ideas>>> Well. Imagine now we can sell TV. CD, home insurance , car insurance before they can have the prescription!! Also, like Tesco, we can make even sell lottery ticket for those patients whose surgery was not available on NHS POLCE lists.. Everyone will be happy>>>

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  • Surely the whole problem with the ghastly NHS destruction - er "reforms" - is that health services are being planned as if they were just like any old commodity in a supermarket. Everything has to have a monetary value, people are all customers and cheapo bargains abound.

    Good to have all the CVs spelled out like that. It says a lot.

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