Streeting’s letter is one-hand clapping

Copperfield would be welling up at Wes Streeting’s letter to ‘tireless’ GPs if he hadn’t replaced the drinking water with vodka
Are you hearing what I’m hearing? If I’m not very much mistaken, it sounds like a little clap, directed at us GPs. Because Wes Streeting has just written us a sweet letter, thanking us for improving access and satisfaction.
It’s all a bit Covid-era saucepan bangy tbh, and I’d be welling up but for the fact that it also has a Zen touch of one-hand clapping mystery. On the one-hand-clapping, he bigs up all things traditionally GP, and on the-other-hand-clapping, all the novel contractual shenanigans he highlights suggest a move in the opposite direction. After all, that new substantive GP contract he re-commits to in the letter is presumably that same new substantive GP contract that wasn’t mentioned in the 10-year plan.
To help him clarify his thoughts, I shall briefly summarise today’s day duty. Around 40 contacts, start 8am, finish 7.30pm, 90% managed without referral. It covered the entire medical curriculum and involved patients who thought they were seriously ill but weren’t (?colon cancer = gastroenteritis, ?angina = costochondritis), patients who thought they weren’t seriously ill but were, (?UTI=cauda equina, ?ear virus = cerebellar infarct), and major crises dumped in my lap from the get-go (8.01am lab call about an Hb of 6.3).
It also involved the usual merry-go-round of patients exasperated at their hospital care, and the refusal of other agencies to help, take on a problem or simply function. And a lot more fun besides, including my final two patients – a seriously ill alcoholic with major medical and mental health issues refusing hospital and a 13 year old girl threatening suicide – who would have kept an MDT hand-wringing for a whole day, with a lunch break, but which were each dealt with via a ten minute slot.
That, as we all know, is the day-job. We gatekeep, we provide continuity, we spot needles in haystacks, we prop up the system and we create order from chaos. Imagine what we could do if we were funded and supported properly and not experiencing existential angst and organisational churn.
True, I didn’t exactly have a Zen-like calm by 7.30pm and I’ve put in a proposal to fill the water cooler with vodka next week. But it did remind me that only we GPs could do this GP job. So I think the real question is, if a Streeting falls over in a forest and there are no GPs around to hear him scream, would a doctor of philosophy do? Or something like that. Look, it’s been long day.
Dr Copperfield is a GP in Essex. Read more of his blogs here