Jaimie Kaffash on Labour’s plans for general practice and why they don’t understand the profession
Frankly, I would make a rubbish politician. I am no fan of ‘horse race journalism’, where politics is treated as a race between two parties, who make strategic plays against one another to get the upper hand. I’d provide far too much substance about any policy on which my opponents could catch me out. I’d ignore polling data and I wouldn’t pay much attention to the front pages of papers that will end up supporting my opponent regardless.
Basically, I would do the very opposite of what the Labour health team seem to be doing. Whenever Labour come out with a policy, I can just picture the focus groups that they tested their policy on, while poring through polling data, deciding if it will be well received in the Mail, or whether ‘Red Wall’ voters will support it, and asking themselves the question of whether it meets that highest standard that politicians can meet – a good old-fashioned, common sense approach. Unfortunately, very little consideration is given to whether the policy is actually any good.
Their latest offering being pushed is their policy for patients to self refer, bypassing general practice. Now, in some circumstances, this might make sense; many would like to book direct with physios, for example. Which they can at the moment, in many areas. But Sir Keir Starmer’s example of patients testing themselves when there is ‘internal bleeding’ suggests that they haven’t really got a clue about how the health system.
We are at a time of unprecedented waiting lists – which Labour have continually pointed out – so I can’t see how allowing patients to self-refer will help.
But, for me, the more important point is a basic lack of understanding of the role of the GP. The most basic function of the GP is the gatekeeper role. They deal with 90% of what they see without referral to secondary care. That’s because their role is to manage undifferentiated symptoms; it is telling the difference between the harmless and the harmful rash, or to decide whether back pain needs a physio or a neurologist. And because GPs filter out most of this for specialists, the specialists aren’t strong on seeing what is harmless. Until Labour understands the role, they should think twice about changing the whole model of general practice.
Instead of developing policy on issues they (willingly?) don’t understand, the party should focus on the overwhelming point about the NHS – one that will, ironically, politically benefit them the most: that the health service is in the state it is as a result of years of austerity, lack of care and fanciful promises by ministers desperate to win the horse race. And not because of NHS staff, as they are trying to portay. Sadly, it feels as though the Labour cavalry have no intention of reversing this rhetoric, even if they do win the race.