The only consolation to being a GP in Folkestone at the moment must be the proximity of a notable escape tunnel. Just to recap the story: Folkestone practices have requested mass list closure on the basis that they are missing 16 FTEs, and the CCG has declined on the basis that it has a legal responsibility to ensure registration with a GP practice, aka tough shit.
This represents a significant tipping point for the profession. Sure, the GPC is trying to work out an objective measure of excess workload – via number of appointments, say, or list size, or decibels of screaming on a Monday morning.
But in the meantime, we have no choice but to take direct action. The situation is a sick joke, so our response should be too, albeit one taken deadly seriously.
Here are some options to save ourselves when the push of work threatens to shove us over the edge:
1 Report ourselves to the GMC. According to ‘Duties of a doctor’, the care of my patient is my first concern, I must recognise and work within the limits of my competence and I will take prompt action if I think patient safety, dignity or comfort is being compromised. Check, check and check. Maybe that ‘prompt action’ should involve us turning ourselves in to the GMC on the basis that excess workload with no prospect of relief is incompatible with patient safety.
2 Sign each other off sick. Much as above, but sullying our (probably exemplary) sickness record for the sake of keeping our GMC slate clean. So, on D-day, we all go off sick with work related stress, the fit note stating we’d be OK to return only when work adjustments make life tolerable for GPs and safer for patients.
3 Use the violent patient scheme. Provoke violence or abuse from potential new registrants by telling them how long they will have to wait for an appointment. Then invoke the zero tolerance policy, ensuring they’ll have to be cared for by another service in a place of safety. This is particularly appropriate, as the CCG’s inaction is in itself an act of passive aggression.
I’m not trying to use stupid gestures to trivialise a situation that is extremely grave. I’m merely suggesting that we should fight absurdity with more absurdity. I have to say, though, that while I’m happy for my Folkestone colleagues to adopt any of the ideas above, I’m disappointed they haven’t had the energy or imagination to come up with these viable solutions themselves. Maybe they’re busy.
Dr Tony Copperfield is a jobbing GP in Essex
