Jaimie Kaffash says we should not dismiss the idea of hiring SAS doctors in general practice
I’ve always said about GMC Charlie Massey that, whatever you think of his organisation, his frankness is to be admired. I remember when he stood in front of an understandably angry audience at the British Association of Physicians of Indian Origin conference a week after the GMC struck off Dr Hadiza Bawa-Garba and explained the decision with humility. It didn’t excuse the decision, of course. And while not a single delegate left that conference thinking that the GMC had acted correctly, there was a grudging respect.
Yesterday, he spoke to a (slightly) less angry audience at Pulse LIVE, but with equal frankness. He elaborated on his ideas for more staff and associate specialist doctors – those secondary care doctors who are not consultants but are not in training either – to join general practice to help alleviate the workforce crisis. Now, I am still lukewarm on the idea. I understand the problems – we might be creating a two-tier medical workforce, will they need supervision, is this cheap labour, how will secondary care cope with the loss of such doctors.
But I would be a hypocrite if I rejected this out of hand. I have asked for radical solutions, and this is a radical solution.
Because the one thing Mr Massey said that really resonated with me is that there is no magic GP tree; we can’t just go and get GPs off the shelf. There is plenty we can do, of course. Increase funding, improve retention with programmes that actually work, stop the GP bashing in the media and by ministers. But even with the Government starting to treat GPs as they should be treated, the years of neglect of the profession means it will only go so far. It is at least a decade before we will see such measures making a tangible difference.
We need an injection of medical staff now. Other roles, such as physician associates, pharmacists, physiotherapists can help, but they are not the same as having another doctor in the practice.
If we were to change regulations to allow SAS doctors to join general practice, it opens up more options. Because, according to the GMC, this grade is growing rapidly, mainly from doctors trained abroad. Would it involve a dermatologist on site, as one audience member asked? Or, as RCGP chair Professor Kamila Hawthorne mentioned, would it involve a new training pathway for them to enter general practice?
At the moment, we don’t know. NHS England have made positive noises, but so far there doesn’t seem to be any concrete proposals. For the moment, such an idea can’t be dismissed out of hand.