Dr Katie Musgrave explains why GPs must be included in decisions regarding the NHS’s future
Remember the legendary L’Oreal advert? The flick of the hair and that enticing glance? The “because you’re worth it” slogan told the world that women had power, were beautiful, and held value.
In the midst of contract disputes and discussions on industrial action, – could L’Oreal’s message have something to teach us as GPs? For all the arguments about funding, low retention rate, morale, new models of practice, scale of working, allied health staff etc. – there is one message that we need to communicate: GPs are worth it.
We manage risk better than any other professional by reducing unnecessary tests, referrals and admissions. We solve problems, therefore improving patient satisfaction and health outcomes. We run an extremely efficient system when properly resourced and given the autonomy to organise our services in ways that suit our populations.
Any contract dispute needs to communicate this first and foremost. No one cares about our wellbeing, pay and conditions, or even our retention. Rather, NHS leaders need to understand that they are destroying an extremely effective and efficient system in search of a false promise. They must realise that they will be left with an almighty and costly mess to clear up. A GP’s unique training makes us invaluable in our ability to safely and swiftly manage undifferentiated presentations. The alternative models being developed will prove more expensive, and the care provided by our replacements will be significantly poorer in quality. We know this, but how do we communicate it to the powers that be?
In my opinion, we also need to show flexibility. If the NHS in its present form is failing (as it appears to be), we should publicly acknowledge the problems, and be open to solutions. Should we be debating social insurance? Rather than pay national insurance, the public could pay into compulsory health insurance policies, and choose their level of cover. Such systems work well in many European countries and further afield, where the basic state provision is often far better than our own. Many of us have friends and family who attest to the better quality care they receive in other countries. I have now heard several Ukrainian refugees express shock at the state of our health system.
For instance, would it be so terrible to consider, for those who can afford to pay, a small fee for a GP appointment? Encouraging better access for the most deprived, young children, or the elderly? We all know care is presently being provided to the worried well, while our frailer, disadvantaged and elderly patients struggle to get through. This worsens health inequalities, particularly in a system under extreme strain, as ours presently is.
There are a host of changes that could be made to put our health service on a more sustainable footing. It may not remain free at the point of access, as was intended in 1948; but could the designers of the system have imagined hundreds of thousands seeking a diagnosis of ADHD? I dare say Nye Bevan would’ve been appalled that our system leaves people dying unattended in hospital corridors, often in conditions akin to a warzone. I suspect he would have been advocating for changes.
Our health system is not working. GPs need to debate the options with calm and pragmatic heads, and they must be involved in discussions about the NHS’s future. General practice cannot be made the scapegoat for a failing health care model that will never remain functional in its present guise. Should we tie ourselves to the mast of ‘FATPOA’, or to good quality, equitable, and accessible care?
Our leaders need to recognise that GPs are worth investing in but, more importantly, that we are ready and willing to be part of an effective solution.
Dr Katie Musgrave is a GP in Devon
Good overview of the position KM. GPs bear the financial, regulatory and legal risk and are worth it as they’re the experts in how to do primary care best for their own patients. It’s why they became GPs.. But where my thinking’s at is that our political masters (both Tory and Labour/Tony Blair thinktank) are more concerned with creating complicated NHS structures that can be privatised. When they’re removed from office they look to these private companies to reward them, eg lecture circuit, board positions etc. Not what works best for taxpayers money but transferring public tax money to shareholders (while keeping the risk nationalised) is the driving factor of their policies. Hopefully I’ll be proven wrong.