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At the heart of general practice since 1960

Dr Peter Swinyard: ‘This will not be welcomed by many of my colleagues’

Chair of the Family Doctor Association Dr Peter Swinyard gives his reaction to the BMA’s blueprint for the future of general practice.

I think that it’s quite a visionary document. It is looking ahead to how we’ll be practising in the future. It is, to some extent, accepting that there will be change.

I know that the change will not be welcomed by many of my colleagues, and I think some people will say it’s a sell out and that it’s the Government agenda just being parroted by the BMA.

But clearly the mood of the moment is for closer working between practices, whatever you choose to call it. Whether you choose to call it federation, or alliances, or shared resources, or whatever.

Things have become so tight in general practice at the moment that, especially smaller practices, are just not going to survive without working together with other people. It just isn’t viable anymore, and we have to start thinking differently about how we’re going to organise ourselves.

There’s a lot of good stuff in there about taking out unnecessary and wasteful competition, when you’re trying to organise local services, especially in the unscheduled care department. And I think they could have gone further with that, and talked in more detail about taking out ridiculous, wasteful tendering processes, when you’re actually just trying to provide a decent service to your patients or to other patients in the local area.

Because these things tend to be done very well by the big companies, but the actual service provision, doesn’t tend to be done very well by the big companies, and I think they could have gone a lot further in that direction.

Readers' comments (10)

  • Dr Swinyard says early on in this piece, "I know that the change will not be welcomed by many of my colleagues, and I think some people will say it’s a sell out and that it’s the Government agenda just being parroted by the BMA". Unfortunately for the rest of the piece he does nothing to alter this view in any way. The BMA is nothing but a messenger for the Government; continually shows itself to be incapable of negotiation and to be an utter disgrace as a union.

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  • I think it is a very good piece by Peter Swinyard.
    I do have to disagree with Thomas, the reality is that the service our patients expect-,admittedly fuelled and directed by politiical rhetoric- is not that which we are currently contracted to deliver.
    Mass opposition " Trade Union Action" to attempting to change to match expectation would make the BMA (or any other body attempting it) subject to the full ire and resource of a nation State.
    As the National Union Of Mineworkers showed us the government can destroy a union, fatally weaken its sector of delivery and decimate its membership.
    The most secure position for the BMA and ourselves is ensuring that the resource to deliver the expectations of our patients to our patients is available to implement the changes.
    When the Government cannot fund the expectation they have created, the BMA and profession needs to be holding the moral high ground of " we where willing , you where too penurious/incompetent" .
    Let the public take their ire on the politician not the medical profession.
    Peter is correctly saying pick your territory for conflicts and the profession should move to a position we we can maintain initiative and advantage.
    By collaborating our efforts we take away the "I must do" that makes the proposed workload impossible.
    "We can do , but The Government must resource approprioately"- including remuneration for performers.

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  • The Government already cannot fund the expectation they have created, efficiency savings are about to bite and blame has been firmly placed on the profession over the course of this parliament and more so under Hunt. When the undeliverable cannot be delivered we have been placed in a position where we and not politicians will be blamed. The BMA is choosing its area of conflict so carefully that it risks having nothing left to represent.

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  • The BMA supports the NHS. Laudable, but at the expense of its workforce. I have done many 80 hour weekends with little sleep. Severe sleep deprivation is pure torture. Only the BMA allows its members to do that. To me, 80 sleepless hours at 30 pence an hour is the epitome of the BMA. What can you expect from such an Union ? No wonder it's members are hugely depressed, burnt out and leaving early. Profit per consultation has fallen to 50 % of it's real value in 10 years and stands at £3 or thereabouts take home. This would be allright except the BMA takes our money to stuff us.
    I take the point of the miner's Union, but I also point out how well the dentists have done when they stood up.

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  • Thomas is correct, we cannot predict an outcome of the " who has the blame when it falls over"
    I love the "Better dead standing than living on your knees" tone of anonymous 11:02 reply.

    Please excuse me if differ,I choose to live to fight another day.
    The measley 30p/hr I also worked for, was won by industrial action of a generation of Dr's in the BMA who had to work compulsory overtime for no pay "to make them better Doctors".
    Battle plan: stick together with the BMA and do our utmost to ensure when the NHS goes belly up the politicians carry the can.
    Play it right we may actually win , but importantly if we loose it is at pyrrhic cost to the political classes.

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  • No one should ever ask to be excused for holding a different point of view Andrew and I hugely respect your opinion. However the GPC, in my simplistic world at least, should represent its membership and I really do not think they have for some time.

    The problem here is the GPC are trying to play politics against people who much better at the "game" than they are. The net result is a Government dismantling the NHS in plain sight and masterfully directing the general public to blame the doctors and nurses.

    Sadly, to me at least, the BMA seem to be rather Neville Chamberlain like in their appeasement to this Government.

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  • We have existing excellent facilities for patients who cannot or do not want to go to their GP - yes it is A&E!
    The facility is there and patients have proved that they will travel so all that is needed is a General Practice set-up at each A&E, paid for by GPs who will be billed for each attendance. This will cost conscientious practices very little as they already provide excellent access.
    We used do do this via the old out of hours system and I seem to remember it working very well, I do not see why it should not be extended to in hours.

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  • George Cook

    If your idea comes to pass I will resign immediately. I remember that old system when certain feckless patients cost us more than we were given to look after them.

    In effect we were paying for the privilege of having them on our books. They were usually indifferent to entreaties from us and were often 'heartsinks' anyway. If we have no right to take them off our list then it is an insult to expect us to pay to care for them.

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  • I do remember an elderly patient coming to a Nursing Home from the USA. He put in so many calls to OOH that our year end bill, sent to us was in excess of £1000. We got £ 45.00 a year for looking after him. This is another madness in GPland. The more services you provide, the less you take home. We have to buy in Liq N. It costs almost £2200 a year. Add nursing/doctor time. We get back 0 £. We pay for dressings and such like. Oh , Never mind, we are all mad to do this.

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  • Andrew Minnagh, did you mention Industrial Action?What about resignation? We can sell our services back. Solicitors do in legal aid. £ 3.00 take home. We do better. We get £ 4.20.

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