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Assuming the position

Claiming that GPs are ‘ideally placed’ to do X, Y and Z might seem flattering – but Copperfield is distinctly unimpressed

There comes a point when the phrase ‘GPs are in the best position to…’ stops becoming an explicit recognition of our key role in the machinations of the NHS and transforms into a sly way of dumping all sorts of crap on us. And that point was, in my view, about a hundred years ago. We’re only slowly waking up to this, though, presumably because the phrase is repeated so often that everyone assumes it must be true – and because we enjoy the attached kudos.

Hopefully, the latest airing of the ‘GPs are ideally placed…’ mantra might jolt us to our senses. The offending party was, yes, you guessed it, Andrew Lansley – speaking at the National Association of Primary Care conference last month. Hot on the heels of us being in the best position to decide how much of the NHS budget is spent, commission out-of-hours care, and take on the PCT’s admin role etc etc, we are now in the best position to take on rationing decisions about drugs. Because that’ll be our job, not NICE’s.

Frankly, this is facile, clichéd bollocks. I haven’t the time, will or resources to establish whether new wonderdrug X is suitable for patient Y in situation Z. I don’t want the flak from punters pointing their pharmacologically deprived fingers at me – though NICE was much maligned, at least we could shelter behind its decisions. And I work with a list of 2,000 patients in a commissioning group of, if reports are to be believed, up to 500,000 – hardly an ‘ideally placed’ or valid demographic viewpoint.

The reflex response to these protests is that it won’t actually be us frontline GPs making these tough decisions. No – it’ll be the poor sods heading up the commissioning groups. And just imagine the fun they’ll have fending off the journalists with their ‘postcode prescribing’ stories, plus the intra-commissioning group internecine strife this will create. Deep joy – I wonder why none but the masochistic and mentally deranged are interested in the commissioning process?

So GPs in ‘the best position’? Oh do shut up. It’s just a stock phrase used to make a shafting sound like a compliment. Hopefully, when the shit really hits the fan, I’ll be in the position to retire.

‘Sick Notes’ by Dr Tony Copperfield is out now, available from Monday Books.

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