Columnist Dr David Turner says it’s no wonder Labour has changed its stance on the partnership model when practices deal with workload dump from every direction without additional remuneration
No matter how hard we kick back, it seems like the medical buck always starts and stops with the GP.
A couple of recent examples sit on my desk. One is a letter from the adult eating disorder service, outlining their diagnosis of an eating disorder and asking the GP to undertake blood tests, ECG, blood pressure and weight monitoring on a regular basis, and then forward the results to the weight management service (in short: do their job for them).
The second letter is from a patient outlining her frustration with the tier 3 weight management service. After a 12 month wait, she was finally seen and rightly expected to be prescribed weight-loss medication. Instead, she was told there is a national shortage of weight-loss drugs, and she should – you guessed it – go back to her GP to ask them to prescribe. In the interim, the patient was advised to try dietary changes and exercise, which of course had never occurred to her (irony detector needle in the red here).
Words – well, publishable ones – fail me with the latter example. If the tier 3 weight management service, whose only real job is to dish out medicines to help patients with weight loss, does not have access to these medications, why would they think I would? Do they think I’m running some sort of Breaking Bad-style cottage industry manufacturing weight-loss drugs in our notes storage room?
So, it would seem like we are expected to be experts in helping patients with complex psychosocial issues gain and lose weight – and we do it all for our capitation fee of £102.28p per year.
On a not unrelated note, we have just learned that the private income we receive from completing cremation certificates will be diverted to fund the medical examiner service that is due to be rolled out in spring next year. In return, the service will complete cremation forms for us. Now, this will result in a loss of income, but surely less paperwork? Wrong. We will still have to complete all the paperwork for the medical examiner but – you guessed it – for free.
The thing is, no matter how much we gripe and groan and go for the jugulars of the idiots who come up with this nonsense (and believe me I have gone for more jugulars of ivory-tower-dwelling-out-of-touch-with-the-real-world-utterly-pointless-rule-devising-idiots than an XL Bully on anabolic steroids), they and we know that we will end up doing the work. Because at heart, most of us are soft-touch cardigan wearers who want the best for our patients.
On a completely unrelated matter, I see shadow health secretary Wes Streeting has just done a screeching U-turn on scrapping the GP partnership model. I can’t say I’m surprised – who else would do this job?
Dr David Turner is a GP in Hertfordshire. Read more of his blogs here