I am writing this just after witnessing a moment in history, when for the first time a woman has been elected to chair the BMA GP Committee. And I am deliriously happy about this because it has only taken 109 years.
But as delighted as I am to see Dr Farah Jameel lead the profession, it’s going to be a tough gig. As we approach the festive season, I can’t help comparing the task ahead with those of a long succession of shepherds leading their flock. The sheep in our flock are of a variety of breeds and graze in many different pastures. Some have access to more grass than others, ending up much fatter.
Sheep are at their best in a strong flock, so the first task is to unite us – within the GP Committee itself and across the wider profession. As all shepherds know, it is not possible to please each and every member of the flock but it is important to engage with as many as possible, before making wise and courageous decisions.
But if the shepherd appears distant and uninterested, the sheep will start to misbehave and wander away. If they go as far as breaking out of their pen, they may even start walking on two legs instead of four, causing much anger and confusion within the flock.
So, apart from the tasks of listening to, and unifying the profession, what else do we need from our new chair?
The issue that most unites us is workload. I love my job when I am not on call, whereas when I am duty GP, I start the day with IBS and a feeling of dread. Why? Because there is no limit to the number of patient contacts I have; it’s often double that on a normal day. Other clinicians go home when their shift ends but GPs stay until the work is done, which is often at the end of a gruelling 12-hour day.
We cannot change this limitless workload without a new contract. A block contract based on list size, as we currently have, has the advantages of predictable income and strategic planning, but where does it fit in a 24/7 digital culture in which customers demand a Rolls Royce service at Škoda prices?
Surprisingly, Daily Wail readers seem to agree with me. When I make the cardinal error of reading below the line, I see comment after comment demanding that we are paid only for what we do, and this makes me quietly chuckle. The general public has zero concept of how welcome such a system would be for most of us, as we would finally be remunerated properly for everything we are doing.
I have written about this in the past, but it is worth restating: as a portfolio GP, my practice role is the most emotionally draining, intensive and high-risk element of my work, but the one that offers me the lowest hourly rate. Unless this fundamental flaw is fixed, GPs will continue to withdraw to pastures new.
So, the primary task of our new shepherd after uniting her sheep will be to ensure they have sufficient grass and water to keep working. Otherwise, they will either flee from the flock or drop down dead.
Dr Shaba Nabi is a GP trainer in Bristol.
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