It is widely known in management circles that organisational change brings with it uncertainty and threat, and that this has the potential to generate illness, stress and absence from work. Successful management understands this and works hard to show leadership, to reassure, and to paint the vision that people can believe in and follow.
Even the most ardent enthusiast of the NHS reforms could not be self-deceiving enough to claim that this is a description of the management style we are experiencing at present.
In the last two years GPs have been told they will become responsible through CCGs for all the NHS funding problems and shortfalls. They have seen consultation rates rise inexorably, the anxiety of CQC inspection, and the worry of revalidation. Income has fallen and complaints, GMC referrals and threats of legal action have grown.
On top of this pensions have been severely downgraded and the profession now faces a draconian attack upon its income in the form of the Government’s contract imposition.
Whether it is good management technique to heap this perfect storm on a beleaguered profession just as you ask it to steer the ship is an interesting question. However, the effects on morale and health are plain to see.
The results of the survey of GP workload by LMCs across the South West made for chilling reading - and the survey was conducted in the first place because LMCs are experiencing a dramatic rise in calls for help.
Devon LMC has seen a doubling of new referrals in 2012 compared to 2011 and other LMCs have witnessed a similar upward trend.
There is a human cost in terms of lives shattered and careers blighted. And the particularly worrying development not fully apparent in those statistics is the fact that experienced veterans - the heart of our profession who have always stood firm - are now calling for help.
The solid yeomanry of general practice is starting to crack, and when that happens everyone should fear for the future of the NHS.
Dr Mark Sanford-Wood is executive chairman of Devon LMC