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Pulse 2018 review: When NHS England’s top GP was caught out

dr arvind madan jon enoch 37 525x350px

dr arvind madan jon enoch 37 525x350px

In this day and age, every man and his dog have a stage on which to opine. Yes, thanks to the Internet, one can express a view on anything – politely or otherwise, for better or for worse – whether or not one is qualified to have one.

But even with such a democratic attitude to having opinions, when it turns out that powerful people are opining when perhaps they shouldn’t, it still causes shockwaves .

Back in the summer, in his role as NHS England’s director of primary care, Dr Arvind Madan admitted to having anonymously posted a series of provocative comments about GP practices on the Pulse Today website.

Under the pseudonym ‘Devil’s Advocate’, Dr Madan had said there were ‘too many small practices’ and they ought to be ‘pleased’ when they are forced to close. He made the controversial statements on the comments section of the site.

Commenting on Pulse’s investigation into practice closures, Dr Madan’s alter-ego said: ‘Most businesses are pleased to see a rationalisation of providers, as it makes the remainder more viable. In the general practice market, there are too many small practices struggling to do everything patients now want for their families in a modern era of general practice.’

But when the controversial commenter’s true identify was revealed, Dr Madan was forced to defend his position, and explain NHS England’s stance on safeguarding and supporting vulnerable practices.

This did little to appease furious GPs, who were outraged not only at what Dr Madan had said from behind the veil of a computer screen, but also at the thought that it represented NHS England policy.

Within a few days, he’d clarified that it didn’t, and promptly fell on his sword.

The resignation came the same day the BMA had issued a letter to NHS England ‘raising concerns’ about Dr Madan’s integrity and ‘demanding action’.

It’s understood that he resigned before the letter was received. But whether he jumped or was pushed, GPs the length and breadth of the country welcomed his exit.

In such challenging times, the profession calls for a leader who will defend and support general practice in its variety of shapes and sizes – and in doing so, stick their head above the parapet, not hide beneath it.


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