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We should all be chucking our physician associates out of our prams


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I’ve just been to one of those GPC new contract roadshow things. Now, I know that I’m paid to react like Private Eye’s ‘Angry baby’, which might surprise you (the being-paid bit), but really, I’m furious! Where is the dissent, the militancy, the smell of revolution?

It wasn’t where I was sitting. Everyone was nodding and grunting approval in a sort of comfy, hypnotised daze as they heard about the list of subsidised staff our networks have been promised. Whereas I was writhing around like a colicky, inconsolable neonate. Why? Well here, off the top of my head, are some of the things from the ‘Additional roles’ section of our brave new world that have knotted my intestines:

  • Clinical pharmacists, social prescribing link workers, physician associates, first contact physios and community paramedics are not doctors, although the clever use of words like ‘clinical’, ‘prescribing’ and ‘physician’ are designed to obscure that fact.
  • I made it clear what I wanted from this new contract in the same way that I make it clear to Santa Claus each year what I want for Christmas, and my list was an unambiguous ‘GPs and less workload’. The outcome in this case might make the giver think, ‘job done’, and might elicit from the recipient a display of false but polite gratitude, but we’ve still ended up with a sack-full of cheap knock-offs.
  • As far as I can tell, these workers are being sequentially pointed in our direction largely because, according to the proposed timetable, they might be available.
  • I already have a pharmacist, and access to both social prescribers and physios, ta very much. I don’t need a physician associate or a paramedic. But I do desperately need mental health workers so, obviously, they’re not on the list.
  • All these new staff will need training, mentoring, monitoring and housing etc, so they will generate workload before they start reducing it, at which point they will probably go off sick, with their roles defaulting, of course, to the GP.
  • The subsidy for their salaries will only continue if we jump through hoops which are very high, doused in petrol and set on fire.

And so on. Come on. Why are we lapping this up? It’s just a pathetic bit of misdirection, we should be throwing our teddies out of the pram, and it has made me go very red in the face. Pass me the nappies, would you?

Dr Tony Copperfield is a GP in Essex

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Readers' comments (11)

  • Suspect Doctors capable of independent thought don't often get invited to these events as they long ago told the BMA precisely where to go. Likely more than one Dr C locally and they mistakenly invited the wrong one.
    Free tampons for the patients though, what a triumph.

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  • Let common sense prevail

    I employed a pharmacist for a short period (3 weeks) to help with the burden of repeat prescribing and prescription queries. When he wasn't covering the duties each day I objected, and was told that 'clinical pharmacists aren't repeat prescribing machines', which I took to mean 'you'll have to carry on doing that yourself, because it's not sexy enough for me'.

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  • Epic BS and epic fail on the BMA/GPCs part.Compleat BS watch the medical workforce dwindle to nothing quislings.

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  • What an absolute shambles

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  • As more doctors step out of the comfort zone of traditional NHS work and others see them blossom and breathe, more unhappy doctors will be brave enough to take that jump. The slowly rolling boulder will gain momentum until no good doctors are left working in traditional roles and traditional ways.

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  • as per Let Common Sense.. -same experience for us.

    Primary Care has to have its general skill set and responsibilities wound down to make it cheap and attractive enough for Private Providers to take over

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  • Totally agree with Copperfield.
    More GPs needed - simple.
    Don`t need all these substitutes who don`t solve problems and just duplicate or even create work.
    What a total mess.

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  • There won't be more GPs simply put:
    1. There is no money, the country is in debt, and nobody wants to pay more tax.
    2. The govt spends money irresponsibly.
    3. The workload comes from quangos, and the govt will not shut down quangos, putting pple 'out of a job', but more accurately, simply free to work in the private sector.
    4. More GPs will come only when they want to come.

    So take my advice, stop asking for more from the government. Start asking for less government. There is only 1 thing that encourages quality and affordability of healthcare, the free market. We (the Western World) have known this for decades. Its time to educate those who don't.

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  • Presumably all this is to cover up the non-arrival of Cameron's 5,000 extra GPs by next year. But why have GPs taken on the role of monitoring long term illness, and abandoned acute illness to A&E departments? Paramedics, nurse practitioners and pharmacists are getting all the interesting new stuff. Glad to have left general practice ten years ago.

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  • GP numbers falling and para GP staff increasing. average mortality rate dropping for first time in years - is there a correlation here?

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