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NHS England’s top GP resigns following Pulse comments



The NHS England director of primary care Dr Arvind Madan has resigned following his interview with Pulse.

He admitted that he had been posting provocative comments under the pseudonym ’Devil’s Advocate’ on the Pulse Today website.

In a statement, he apologised to small practices following his interview in Pulse, where he suggested GPs should be ‘pleased’ when small practices closed. 

The BMA said It had written to NHS England ’raising concerns and demanding action’ earlier in the day, but it is understood that Dr Madan tendered his resignation prior to receiving the letter. 

In his interview with Pulse, Dr Madan stood by comments that ‘rationalisation’ occurs in every market, and that there are ’too many small practices struggling to do everything patients now want for their families in a modern era of general practice’.

It was later reported that these comments were originally made in the comments section of Pulse Today, 

In his statement, Dr Madan said he had ’lost the confidence of some of my colleagues’ with the comments reported in the Pulse interview. 

He said of his comments on Pulse stories: ’As part of my attempts to challenge the negative views – and even conspiracy theories – held by a small but vocal minority in the profession I posted on an anonymous online forum used by GPs.

’It was never my intention to cause offence but rather to provoke a more balanced discussion about contentious issues acting as a devil’s advocate.’

Dr Madan said his comments didn’t reflect NHS England policy, and he apologised ‘unreservedly’ to small practices. 

He said: ’In my 23 year career as a frontline GP I have worked in practices of all sizes and have always believed that smaller practices serve a particularly crucial role.

’I know they work tirelessly, alongside all primary care colleagues, to serve their patients and perform a role that goes well beyond being their doctor. GPs in smaller practices serve a particularly vital role as a point of constancy in the lives of often very vulnerable patients.’

Earlier, the BMA had sent a letter to the chief executive of NHS England, Simon Stevens, about Dr Madan. 

Dr Mark Sanford Wood, BMA GP Committee deputy chair, wrote: ’I am writing on behalf of GPC England to inform you of our serious concerns regarding both the comments made by Dr Arvind Madan in Pulse magazine suggesting that GPs should be “pleased” when small practices close, coupled with his postings under the pseudonym “Devil’s Advocate”.

’His damaging comments have caused significant anger from the profession at a time when GPs require support from NHS England.

’The key revelation from the pseudonym postings, specifically his belief that individual GPs losing their practice, and their business, is not only necessary, but something he thinks should be welcomed, has severely compromised his integrity.’

RCGP chair Professor Helen Stokes-Lampard said: ’The college has had a constructive working relationship with Dr Madan, but his comments about smaller GP practices did not land well with many of our members, and once revelations about his anonymised postings were made, we understand that he felt his position at NHS England had become untenable.’

She added that the RCGP ’looks forward to building new relationships and working constructively with Dr Madan’s replacement’.

Dr Madan was coming towards the end of his three-year secondment to NHS England from the Hurley Group Practice in east London.