Columnist Dr Copperfield argues that the splintering of the general practice workforce will make contract negotiations challenging
Not knowing the details, I can’t comment on the individual case of the practice making salaried doctors redundant on the grounds of new ways of working – including the ‘skill mix’ provided by the ARRS army. But it’s certainly in tune with the funereal mood music of a sudden lack of locum vacancies and salaried posts.
And that I can comment on, with a carefully considered, ‘Blimey!’ Am I glad I’m not GPC chair at the moment. Can you imagine trying to negotiate a new contract when all the usual tropes of general practice have been turned on their head?
Workforce crisis? Apparently not, given the number of redundant and un- or under-employed GPs currently kicking their heels. Wanting to reward continuity within the contract? How do you reconcile that with the fragmentation of the new shiny multi-role version of general practice, unless of course you prefix the word with ‘dis’. Workload cap? I don’t think so, not when you’re showing GPs the door.
And, most of all, potential industrial action? Good luck with that. ARRS staff, remember, were supposed to plug a gap, not drive a coach and horses through it. How has this happened? What was once sold as a necessity is increasingly looking like a choice. Which is where the profession splits: into those who value the core generalist role and despair at its de-construction; versus those who think the diametric opposite, and worship at the skill-mix altar. So try getting strike-action consensus out of that.
If there is a sweet spot between those two extremes, then it’ll only surface if GPs are included in ARRS, as has been suggested. GPs would eat up more of the budget but be more, well, GP. If the direction of travel changed as a result, we’d know we hadn’t sold our professional soul down the river.
In the meantime, I repeat, blimey, good luck GPC, and, being old and salaried, yeah, I’ll take the redundancy pay, ta.
Dr Copperfield is a GP in Essex. Read more of his blogs here
READERS' COMMENTS [7]
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Spot on as usual DC, welcome to our bleak dystopian future, one we have acceded to with either a pathetic whimper or blind allegience always with the usual moaning, one that we are all going to be forced to use at some point
If GPs pass all the simple cases to ARS staff then they will suffer a heavy depressing workload and the job will be more even more stressful and demoralising. We are creating our own worst future.
can Pulse advise if this practice is being run by traditional partners? easy to throw mud here but one hopes individual partner profits are not being ”protected” vs the level of care offered to their list. Nobody polices the level of care a practice offers which is a bizarre way to run health service with public money
Primary care is being systematically dismantled and reconstructed in a government approved model, i.e. cheaper and (being employed) more biddable. We are lambs to the slaughter, and playing the government’s game by facilitating this direction of travel. It will of course be a disaster. Access? Yes. Continuity? No chance. Multiple symptoms and complex/atypical presentations? Good luck with that too. Flexing the rules in a system increasingly pro-forma and flowchart driven? No way. Primary care is a societal pillar which is about to collapse. And in doing so it will bring the rest of the house down with it.
The present overall situation is the medical equivalent of stagflation.
It’s just sad. Take a look at almost everything else in the UK at the moment. It’s the same. There is no way back. Its painful because its real, and because today will become yesterday and what once was, the past.
And have a thought for the patients, luckily I am both a GP and a patient, its chilling to helplessly watch people being misled, misdiagnosed, mistreated and patronised (its your fault you are ill, you should have done this or its alll in your mind etc). I try to warn people I know and they just say, ‘but they did lots of tests’, they don’t want to know because the truth is terrifying.