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Get it right, Steve

As we come towards the end of the 'listening exercise' on the health bill, Jobbing Doctor has some advice for the chair of the NHS Future Forum

The future of the NHS is quite possibly resting in the hands of one man.

That man is Professor Steve Field.

I think Steve is well qualified to be at the centre of the oncoming storm. He is, after all, a GP who still sees patients at his practice in Birmingham. He can refer to the patients' stories when he is reflecting on the views that he has heard, and the practice is in a mixed, though largely deprived, inner city area.

Steve also has had a meteoric rise in medical politics, becoming regional director of GP education, postgraduate dean and chairman of the RCGP council all in the space of a few years. He developed a sure-footed skill in dealing with the media, and only narrowly missed out on becoming the Government's chief medical officer.

Steve now mixes with the great and the good, and will be immersed in policy, strategy and representing the profession in all the influential meetings at the centre of Government. He is now flying high. But does that mean that his feet are no longer on the ground?

There are some who say that Steve has lost touch with his colleagues and will pretty much do what he is bid by the Government. They argue that he has been asked to neutralise professional opinion, will acknowledge concerns whilst rebutting them in his report, and will give qualified but decisive support to the Government.

I have met Steve in the past, and have always found him to be a man of integrity. That is how I have always seen him, and that is how I would expect him to behave. I cannot believe those who say that he will do whatever is necessary for his own advancement. But it is certain that, over the last few years, Steve has not made pronouncements that have been popular with the profession.

You can usually tell what a person is like by the quality of the people that they are friends with, and Steve is mixing with a lot of people who are very persuasive and influential, but are not friends with a system of healthcare delivery that is the way we have it in the United Kingdom.

I have some advice for Steve Field: I don't know if he will take it, or even if he reads this blog; but here it is, anyway.

Firstly, your report is absolutely crucial. Do not let anybody else draft it. Write it yourself. We will know from the way it is written if it has been written by a civil servant.

Secondly, you must not stick to the narrow brief that you have been given. If this is going to be the report that will have your name on it for posterity, then you must take into account the bigger picture.

Thirdly, you must address some of the fundamental flaws in the legislation: why is it that the legislation has removed the duty of the secretary of state to provide a comprehensive service? How can we maintain a coherent service when the potentially profitable bits will be cherry-picked by the private sector? What is to happen to education and training that have already been so damaged?

This report will the the making or the breaking of you, Steve. You owe it to the service, the country and your colleagues to get it right.

In your hands.

The Jobbing Doctor is a general practitioner in a deprived urban area of England.

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