Posted by: Tony Copperfield
21 April 2016So now, at last, those interminable jokes about Jeremy Hunt’s package can stop. Because we’ve seen the size of it. And it’s massive. Sixty pages thick. Sixty pages, the unkindest might say, of complete cock.
We were looking forward to something tangible and immediate
Now that, I think, is harsh. Because it does have some positive elements. Funding, for example, to the tune of more than half a billion quid, which is always good. Clear plans to stop secondary care dumping on us. Pots of dosh for staff training. And a properly resourced stress-buster service to help talk us down from the window ledge.
But the cynics will point out, with some justification, that there’s a significance in the repackaging of Hunt’s package as a ‘Forward View’. Because that changes the emphasis from something which we could unwrap here and now and find potentially transformative, into something which, instead, is vaguely out there on the horizon and will probably seem forever just out of reach.
And that’s a real shame. Because, given that we’re all on our last legs, we were looking forward to something tangible and immediate to give us some breathing space. Not more money, in fact, but less work. After all, if there are these resources sloshing around the system, how about using some of it right here, right now, to ease the burden before we gasp our last?
It could have been something relatively modest, like providing a proper nursing and community geriatrician service to cover every care home, thereby taking the GP out of the equation. Overnight, two sets of lives transformed, with both no longer having to hammer on the windows screaming to be let out.
Or why not something truly seismic. Something to make newbies want to join and oldies happy to stay? Like acknowledging that, for too long, GPs have been cramming two jobs into one by providing open-door acute access and, simultaneously, a service for sub-acute and chronic illness. So how about contracting out all acute care? All those ‘on the day’ requests, those ‘urgent visits’, those impatient ‘extras’. In other words, those myriad things presented as urgent which screw up our nice, pre-planned, potentially professionally rewarding routine, as they do, every single sodding day. Fund it to go elsewhere, I don’t care where, to see someone else, I don’t care who.
That’s the kind of thing we were looking for. Something that would make a difference, now, before it’s too late.
Instead, we have the usual fannying around at the periphery, with a ragbag of funding promises, recycled initiatives, random pilots and hollow resolutions. To implement any of these requires an effort of will, energy and time on our part that we simply don’t possess, and then might only be of vague help at some point in an even vaguer future.
The arrow emblem adorning the cover of this latest quasi rescue package is big, bold and, presumably, pointing the way. But it’s really hard to have a Forward View when the very architects of this supposed salvation have rendered the job so unbearable that, driving to work each day, you can’t possibly Look Forward.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield
Readers' comments (12)
LISTEN MAN | GP Partner21 Apr 2016 1:16pm
Mr Hunt - The only thing to forward to is early retirement!!
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Anonymous | NHS Manager21 Apr 2016 2:55pm
Public Health England must wake up and educate patients that a sore finger, runny nose or IBS flare does not need a GP appointment.
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Kaiser Chaudhri | GP Partner21 Apr 2016 5:20pm
Copperfield is right, this is all jam tomorrow policy and will do little to dissuade older GPs from retiring or persuade young doctors to enter GP. He makes sound suggestions of a Geriatrician-run service that takes over the care of residential home patients and an urgent care service to see those that demand to be seen on the day. I would add the removal of CQC from any involvement with GP services which are already over regulated.
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Anonymous | GP Partner21 Apr 2016 7:31pm
Read James Kirkup in the online Telegraph to think what right wing tories think of general practice
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Anonymous | GP Partner22 Apr 2016 8:23am
James Cockup is a jealous little jeremy.
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Anonymous | Work for a pharmaceutical company23 Apr 2016 10:23am
Gps get an undeserved bad press, but the system puts them centre stage, the 'free' system they operate under encourages appointments for a poorly finger a headache and tummy upset. We need to look to our European partners where pharmacy has a much wider role, Statin price is between £1-2 but dispensed at £8.40 and the patients don't even get a choice on which drug or side effect profile, where's the fairness in that for those who work. the free for all benefits some more than others!!
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Anonymous | Practice nurse23 Apr 2016 10:49am
GP's need improved management not CQC style. Many do not want interference because many abuse independent status by staff being on minimum wage, holiday entitlement, and most of all, poor recognition of skill mix.
GP's are often under the delusion that only a GP can have any medical knowledge whatsoever and poor use of experienced practice nurses is commonplace.
If only GP practice was more multidisciplinary and less adversarial, all concerned would have more work motivation, appropriate post grad training, communication and support from colleagues, and better organised patient care.
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Andrew wijnberg | GP Partner23 Apr 2016 11:39am
Copperfield for Minister for Health! No seriously, the usual biting wit but laced with practical suggestions. If only our so called leaders also had their hands on the actual job.
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Craig Arnott | Other healthcare professional23 Apr 2016 12:41pm
Is there anything you can't whinge about? Have you really been dealt that bad a hand? If so what about trying to implement some of your ideas. They seem logical and would get you away from the profession you seem to have grown tired of. If you haven't the finance or know how to start up on your own how about trying to implement them through your Federation or CCG? Alternatively I'd be happy to look into it with you.
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Karen Morton | Consultant23 Apr 2016 1:51pm
Dr Morton's - the medical helpline is up and running and ready to look at taking those acute illness or minor concern phone calls. We really could take the stress out of general practice for both the GPs and the patients. Andy Burnham said that the NHS cannot be a service of convenience, so another solution, like ours must be the answer
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