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GPs buried under trusts' workload dump

Gerada: the GP profession has become 'helpless'

GPs should be lobbying against the Friends and Family Test, NHS Choices, and ‘nasty’ inspection and regulation processes that undermine their clinical professionalism, former RCGP chair Professor Claire Gerada has said.

Speaking as part of the opening debate asking ‘Is general practice sustainable in its current form?’at the Pulse Live conference in London today, Professor Gerada lamented that the profession had become so ‘helpless’ and called for doctors to take action.

During a question and answer session, Cambridge GP Dr Fiona Cornish asked whether GPs should relinquish some of their gatekeeper roles to reduce their workload.

Fellow Pulse Live panel member Dr Peter Swinyard replied that GPs practice in fear of negative patient reviews being used against them in CQC inspections if they deny a patient a referral or test.

In answer to Dr Swinyard, Professor Gerada said: ‘So lobby for the abolition of the Friends and Family Test. Why have we become so helpless? Get rid of the Friends and Family Test, get rid of NHS Choices, insist the CQC have a compassionate inspection process, lobby the GMC to stop their nasty systems and treat doctors as they wish we’d treat patients.

‘That’s what we should be doing, I don’t understand… the real question is why have we become so helpless?’

When challenged as to why the RCGP wasn’t lobbying on the profession’s behalf, Professor Gerada said it was LMCs’ responsibility.

Professor Gerada added that despite the need for change, general practice was a better place to work than the rest of the NHS.

She said: ‘The NHS is a toxic place, the NHS is toxic at the moment… general practice, even though it’s awful at the moment, is far better than working in a hospital.

‘And the real secret we all hold on to, is actually it is a lot better than working on the other side of the NHS.’



Readers' comments (74)

  • Dr Gerada perhaps you have had time to reflect upon your tenure as RCGP lead. I cannot help feeling that GP land has become toxic, as you describe, partly because of people like yourself. We have a class division in general practice because of the policies and practices you helped to support..... (body corporates such as yours employing legions of salaried doctors.........whilst yourself openly calling for an all salaried model etc)

    Also whilst at the head of the RCGP you oversaw a most shameful debacle of the CSA exam. The RCGP misrepresented the findings of prof esmails study which led to a public spat with the esteemed expert on racism and also a court case with the BAPIO.....

    Now we have a situation where its younger doctors vs senior colleagues in retirement and pension stakes, partner vs salaried in respects to working conditions. we have younger GP's and now mid career leaving for careers abroad and new trainees choosing to locum rather than commit to career GP;

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  • Whys is it always somone elses problem,non of our leaders(or ex leaders) shoulder any responsibility when it come to the mess the proffession is in.This hasn't occured over night has it.

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  • I resigned from the RCGP under Steve Fields tenure, and it did not get better under Dr Gerada. I was depressed to hear Dr Gerada say that the partnership model should go when she is a director of "London's leading Provider of GP services".
    If this is what our leaders think, no wonder we are in trouble as a profession.

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  • Nothing to do with me guv....When did you speak out when you were in the Chair Clare? How many other positions are you in now as well as the part time GP one? Don't blame wimpy GP land when you don't even live in it GPs need people who are representing GPs not their own careers

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  • GP Profession has always been helpless. The mess started from 2004 when BMA got the contract worded wrongly.

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  • Ha,ha. I wondered how much flak i would get for challenging our own behaviours. I have not blamed "wimpy" GPs as some have said - rather why we, as the most powerful speciality, in the most powerful and trusted profession have developed such learnt-helplessness.
    And before you attack me for not speaking up - can I remind you that over the last 5 years I have personally spoken up
    a) against the HSCA
    b) against dementia screening
    c) against the medicalisation of life
    d) against statin
    e) against CQC inspections
    f) against the onerous regulation regime we have
    and many many other topics
    I speak to my values and for my profession and continue to do so.

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  • And re the Partnership model
    I am not against this - I am against and think is time-expired, the independent, self employed model. Those who think we GPs are independent are in denial. I think the best model is, as I said at the conference, us becoming primary care provider organisations - led by GPs and all salaried to the organisation. This does not mean the abolition of our practices - or indeed partners (though would change the model) but would mean we would not be dumped on so much.

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  • I read this with such sadness. I only finished VTS in 2013 and when I think of my CSA study group (we were four) - one has already migrated to Canada.- another had lost her zest for GP in less than a year and has already resigned her salaried post to become a locum and the other moved away with her husbands job.

    When I was in my registrar year -one of the 4 partners left for Australia. He has not been replaced- they have advertised many times.

    There are many friends and colleagues who I now know have moved to Canada in the last few years.
    Everyone of them describes their move as the best thing they ever did.

    All of the GPs who I know who have migrated--not one qualified before 2006! That is quite scary.

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  • Are there partnerships in Canada?

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  • Dear Clare

    many thanks for responding and explaining your position.

    'Those who think we GPs are independent are in denial' - I agree. But surely is not the problem the contract?

    I am a salaried GP and I hate it. It is boring and I basically do what I'm told and keep my manager happy with phrases such as 'it's a challange, unmet needs, let's learn from this etc !'. I am salaried out of convenience not of desire. I would prefer to have my own practice but the problems are;

    1. frankly rubbish contract
    2. poor pension terms

    if these are improved then i'd go for a partnership.

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