’General practice has failed as a profession’ – this was a headline in the Daily Mail this weekend. And again in Pulse on Monday. In the current climate of denigration of the medical profession and of GPs in particular, this didn’t really come as any big surprise. Just another journalist or politician continuing in their quest to devalue and demoralise medical professionals. But I was surprised when I read whose words these were, and I soon understood the uproar that ensued in the online GP forums.
I am ashamed of the inspection process
Sadly these were the words of Professor Steve Field, the NHS’s Chief Inspector of general practice, and yes, a practicing GP himself. Not only does Professor Field believe that we have failed as a profession, but was quoted as being ‘ashamed’. In his interview he was referring to CQC failures, a bone of contention not only for him, but also for every GP in the country. The furore around CQC is quickly spiralling, not only from the seemingly cruel methods of inspection and stringent standards, and the ways that failing practices are dealt with, but also because of the looming hike in fees of 600%.
Professor Field may be ashamed of his fellow GPs, but I am sure I am not speaking only for myself when I say that I am ashamed of the inspection process and ways that ‘failing practices’ are dealt with. I am ashamed that a high-profile GP could take part in the witch hunt against his colleagues, especially a GP who has stood as chairman of our Royal College. Jeremy Hunt, who has championed Professor Field in his role as Chief Inspector has recently tweeted about how ‘no-blame, open culture is so crucial’ and that he was ‘working with Bruce Keogh 2 create supportive culture 4 docs’. However this seems to be in contradiction to the methods currently being used to regulate provisions of care, where fear plays a big part. As the trainee and newly-qualified GP representative for GP Survival, I know how anxious and uncertain comments like this make those about to become GPs. This is an example of one of the reasons why we see so many doctors leaving general practice so soon after qualifying – they are made to feel entirely worthless.
During the interview, Professor Field mentioned a few points that demonstrated the failure of general practice, including:
– Patients having to queue for 4 hours to get an appointment
– Secretaries having to sort through results and letters, choosing what is important for the doctor to see
– Surgeries being ‘abandoned’ because of lack of locums to cover when a partner needs to take leave
I don’t think it takes a genius to put this picture together and see an under-resourced, struggling system rather than a bunch of failing GPs who should be ashamed of themselves. Instead of pointing the finger of blame and further demoralising a dwindling workforce, why doesn’t Professor Field have a chat with his pal, Jeremy, imploring him to inject the necessary resources in order for practices to stop failing their arbitrary standards? The powers that be need to support our ‘failing’ practices, finding where the problems lie and encouraging growth and change. Closure of practices that are deemed inadequate will merely put pressure on surrounding practices who are, in all likelihood, already struggling.
CQC is the problem. The whole process of inspections and ratings is shameful, not the hard working GP struggling to jump through hoops whilst keeping up a decent standard of care. Also shameful is the way that practices are named and shamed, causing distress not only to all the staff under that roof, but also to the patients who trust those looking after them. Until current inspection processes are scrapped and an alternative, which is fit for purpose, is put it in its place, general practice will continue to struggle to progress and move on from this all-time low.
Dr Rebecca Jones is a GP in Hastings and Trainee/NQGP Representative for GP Survival