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
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READERS' COMMENTS [12]
Please note, only GPs are permitted to add comments to articles
antidote for NewSpeak and fabulous reminder of the value of a GP
👏👏👏
So true. Only GPs properly trained can do this job without flooding the rest of the system but they never seem to get that we can’t just be replaced by a cheaper model- or maybe they deep down realise it but it infuriates them .
This really summarises our typical day as a GP; quite quaint. Thanks.
While his one hand claps, the other clasps a draught of poison. If a Streeting falls over in the forest – I’d leave it there to rot….and Wes’s letter reminds me of the vet whispering sweet nothings just as he was putting our lovely dog to “sleep”….
Nice duty day description – woebetide any AI that “thinks” it can replicate a GP’s level of working !
Apparently GB News are running a story that NHS GPs are being paid £153 to prioritise treatment of “Asylum.seekers”.
Anyone know what is happening?
Yeah, I do. They ran that story between the one about Tommy Robinson in the running for Poet Laureate and the one about Nigel winning the village fete prize by growing the largest pair of plums in his well-soiled underpants….”oooh, they look so big, Nige” purred Marge, the head judge!!
But really Dave, don’t tell me you sit watching Great Bollox news, can of lager in hand, in your spare time?….you should take up cross-stitch or needlepoint, mate – it’ll be good for your blood pressure.
Haddock, dictionary definition: bottom-feeding fish….whaaat? 😉
Hasn’t it always been the problem, that the people responsible for planning and running the health system have never understood the value, purpose or complexity of what we GPs do?
In their need to design models and cut costs, they have simplified the complexity of what we do to the point where it no longer describes general practice. In these models, patients do not appear to be conceived of or treated as complex, multi-faceted individuals, but as Units Of Economic Activity who can therefore be modelled on their spreadsheets. The assumption seems to be that patients always present with single well-defined problems that therefore can be pushed into algorithms that can be safely and effectively managed by AI or ARRS staff.
But this is nothing more than a convenient fiction, that always breaks down when they try to apply this false logic to the real world.
When it is their turn to fall ill, they would not want a nurse or a PA looking at them.
And of course “Everybody knows what a GP does”
December a few years back, the day of my practice “Christmas Do”, my last patient was a well known SMI rarely attender, who attended in a hawaiian shirt and their underwear, having shaved their head on account of the messages from the demi-gods in a parallel universe. I have asked ChatGPT what it would do in this situation, and it hasn’t yet given me the correct answer.
🖐️ 🤦♀️