Dr Laurence Buckman has warned that GPs are not prepared to ‘shore up’ urgent and out-of-hours care and cannot become ‘providers of last resort’, in his last address at the LMCs conference as GPC chair.
He received a standing ovation after accusing Jeremy Hunt of ‘spouting rubbish’ in continuing to blame GPs for the pressures on A&E services, after a series of speeches from the health secretary claiming that the 2004 GP contract has had a ‘devastating impact’ on out-of-hours care. Mr Hunt is due to make a major speech on general practice later this afternoon.
Dr Buckman also told GPs that they may have to work in bigger partnerships or ‘federate through some kind of franchise system’ to cope with the economic pressures faced by the profession.
Speaking at the 2013 LMCs conference in central London, Dr Buckman said: ‘Despite all the evidence, Hunt continues to tweet that it is all the fault of the GP contract. This is because he does not want to bother with the facts when he can have a bash at those of us who, on his own admission, are over-worked and strained beyond endurance.’
‘Hunt has continued to spout this rubbish when on Tuesday he told MPs that our contract had had “devastating impact” and that pressures on A&E services were “direct consequences of the disastrous changes”.’
Unless the Government changed its approach, patient safety would be endangered, he added. ‘If we don’t work together constructively to find a way forward, we’re quickly going to have doctors all over the country so desperately worried about their patients and their colleagues that they will follow the example of a group comprising almost all of the medical leads of emergency departments in the West Midlands who last week wrote an open letter to trust chief executives and CCGs to say they could no longer guarantee safety in their units.’
‘GPs are not prepared to shore up a system that has been rendered unsafe by unwise political meddling. We are happy to work closely with others, including CCGs where there is full GP input, to improve out-of-hours services.’
Dr Buckman warned that GPs were already overloaded with work. He said: ‘The fact is GPs are undertaking more consultations per patient and we are diagnosing and treating more conditions that ever before. The fact is that GPs cannot become the providers of last resort for urgent out-of-hours services.’
But he also told delegates that economic pressures meant that GPs would have to work differently in future.
‘We may have to work in bigger partnerships, or federate through some kind of franchise system as some GPs have done,’ he said. ‘I think that economic pressure is going to make this happen and we would be wiser to lead the wave rather than follow it. Why do some patients want continuity with few GPs while others want a quick service whenever they access it? Is it just about the age of the patient and their co-morbidities?’
‘GPC and LMCs have to get on and find out. Our debates this week will get this going but we all need to recognise that the aspirations of younger GPs are different. They do not want to work in the same way as many of us have always done and we have to consider their futures too.’
Dr Buckman also warned that some inspectors and appraisers would ‘see their role as enforcers’ and his mention of the new chief inspector of primary care received loud boos.
He said: ‘On the regulatory front, just when we thought we could not be more closely observed, we can now expect a new chief inspector of primary care. GPs are committed to providing high quality care to their patients and will work with the new regulatory framework to ensure that patients continue to have confidence in their local practice. But, as ever, the system needs to be practical, proportionate and supportive.’
‘With revalidation and the CQC registration of general practice – both introduced in the past year – we have liaised closely with the organisations involved to make it work, for patients and doctors. But despite all this effort, there are some appraisers and inspectors who see their role as enforcers, out to rid the service of GPs who do not fit with their view of what GPs should be. How such people get into positions of power over others I do not know.’
Dr Buckman, who steps down from his role as GPC chair after six years in July, also paid tribute to BMA colleagues and members.
‘My future is to go back to my practice and try to stop the Government from bankrupting it,’ he said.
‘Some of you will breathe a sigh of relief, though not as much as my wife. I have been privileged to be elected to the task, and to have received the support of most of the 46,000 GPs.’