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What do we want? (Apart from money)

What do we want? (Apart from money)

In light of the BMA referendum result, Dr David Turner ponders how the DHSC could help cut out the rot eating away at general practice

99.2% of GPs voted to reject the Government’s pay offer of a 2% uplift. Only 0.8%, 155 individuals, voted to support it. I just wonder, as did Pulse editor Jaimie, what exactly those 155 thought they were voting for? Maybe they thought ‘Two Percent’ was the name of a rap artist?

At least we now know what we think of the DHSC’s insulting offer of a real term’s pay cut. I daresay, if there had been another question about what we suggest they do with their offer, we could have impressed our gastroenterological colleagues with a detailed knowledge of the capacity of the lower GI tract…

Like a well-planned war, we need to think about what we want at the end of the hostilities. It may not seem like it, but money is far from the only issue. Let’s suppose, just for a moment, that we live in a fantasy land and the health secretary, temporarily transformed into a fairy godmother, grants us an inflation matching income uplift. Would that be enough? Frankly, no.

For general practice to be sustainable, we need to prevent further erosion of the generalist role and cut out the rot that is eating away at us. 

The list of gripes individually are not hugely significant, but in sum, they are grinding away at us. In no particular order, they are:

Start valuing continuity of care. Patients certainly do, and it reduces hospital admissions. It really is a no brainer to financially reward practices who demonstrate the best continuing care for their patients.

Don’t replace us with other healthcare staff. ANPs and PAs are not GPs and cannot act as substitutes for us. We need the DHSC to explicitly say this and mean it.

Let us deal with death. It has always been our responsibility. We confirm the deceased are indeed dead and then complete the appropriate paperwork to certify this fact. Handing this over to a medical examiner, who will never have met the patient or their family, seems at best illogical and at worst a shocking waste of taxpayers’ money. And, before anybody says Shipman, don’t, that was 24 years ago.

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Scrap online referral forms.We find them horrendous as do consultants. Let us write letters again. They work. 

Stop making us the fall guy for medication rationing. If the DHSC wants us to stop prescribing something, then have the balls to blacklist it.

Start properly holding secondary care trusts to account. If they are not fulfilling their contract, by dumping work they are paid to do on primary care, financially sanction them. That will stop them doing it, guaranteed.

Let us use ARRS monies to pay for more GP time. There is no reason on earth why this can’t be done. We want it and so do patients. You can change this now, so stop pretending otherwise.

Get rid of annual appraisals. Waste of time and money. You could scrap it and nobody will miss it.

Ditto for CQC inspections for the majority of practices.

Most importantly though, just leave us alone. Give us the money to do the job and leave us to it. We know what we’re doing. 

It’s that simple, really.

Dr David Turner, GP in Hertfordshire 



Please note, only GPs are permitted to add comments to articles

Jonathan Heatley 16 April, 2024 7:03 pm

Totally agree. Well summarised list of great suggestions.

Decorum Est 18 April, 2024 2:37 pm

Well said.