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Independents' Day

A grade C-section for effort

Editor’s blog

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This may be the busiest time in the year for news. Conferences are in full swing, which always brings outlandish promises and statements from politicians (and truly, horribly embarrassing attempts to connect with voters).

It’s around this time of the year that reviews get published, such as the interim findings from the review of the partnership model from Dr Nigel Watson. There are also deadlines for commissioners, such as rolling out seven-day access across England from 1 October – despite a lack of appetite from the public for extended access. And that’s without even mentioning the advertising watchdog scolding Babylon.

But let’s face it, there is only one story any GP is talking about right now – the proposal from NHS Oxfordshire CCG that the local trust’s maternity services might be saved by training GPs to do… C-sections. Yes, you read that right.

First off, let me say it is highly unlikely to happen. It was one of nine options and the CCG has already distanced itself from the suggestion post-publication. It said: ‘Out of respect to those who suggested this option, it has been included at this early stage (before shortlisting) for completeness’ – about as damning as a CCG statement will get.

It’s an extension of the thinking that gaps in secondary care can be plugged by a bottomless well of GPs

But there is a reason this story has generated so much interest from GPs – because it is actually believable. It’s an extension of the current thinking that the gaps in secondary care provision can be plugged by a bottomless well of GPs ready to step in. It is the same attitude that drives the Government to persist with extended access, despite the fact general practice is unable to cope with routine weekday care as it stands. It is the same attitude that is trying to put more and more specialised care in the hands of GPs – despite the massive patient safety implications.

This particular proposal may be dead in the water. But it is indicative of a dangerous strain of thought among commissioners right now.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at



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Readers' comments (1)

  • Vinci Ho

    Not interested in the superficial meaning of the idea but more importantly, the meanings behind:
    (1) One word to describe this : Desperate .
    The state of resources in the NHS has become so dire that technocrats and policy makers are not only out of ideas , but also losing any control of the downfall. Whose fault is that? (I will let you answer this one).
    (2)Evidently , the trend is now getting the ‘less senior’ grade to do the jobs of the ‘more senior’ grade ,for instance ,student nurses becoming district nurses , nurses or physician assistants becoming GPs , salaried GPs replacing all partners and in this article, GPs becoming obstetricians to perform C-section(10-15 years ago , nobody would ever have an appetite to consider this)
    (3)Like some previous comments suggested , training and getting GPs to do complicated procedures is not unheard , especially in the much less resourced and developing countries. But is that really what this government wants to take NHS to?The whole idea of training a GP to do C-section is probably , not stupid , but exciting to those GPs with extended interest (previously called GPwSI) in O&G .But it goes back to the primal argument that adequate resources(money , time , manpower and expertise simultaneously) must be there first. To fix NHS and general practice, it will be costly. Otherwise, this is another New Emperor’s clothes or Big White Elephant in the room.
    (4) The saddest thing is how out of touch these so called ‘visionaries’ are amongst the technocrats. If you ask me , we are where we are, I would rather to have new investments in developing AI robots to perform C-section (like what I wrote about around the clock social care in another comment) , if one is so desperate to find a ‘solution’ to progress.
    (5)Confucius had a rather conservative saying in Analects,’ If the label is not correct , the words cannot ring true (hence , not convincing) . And if the words cannot ring true , the task can never be completed successfully.’ (名不正 ,則言不順。言不順,則事不成)。
    I suppose there is some truth in this........

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