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Bend over and hand me that traffic cone

Copperfield finds himself raging at the radio, after a minister tries to justify Government proposals to shake-up the NHS

I presume it's just another sign of my inevitable descent into grumpy old gitness. Or perhaps all those years at the coal-face have finally ground me down to a psychotic, burbling wreck. Whatever. Today, I found myself screaming at the car radio.

I'm driving to the local nursing home to see a little old lady who ‘Feels a bit funny' (her words) and ‘Looks a bit funny' (the staff's words) – so I'm already in a terrific mood, not knowing whether I'm going to encounter someone who's severely ill or dressed as a clown.

Then I hear some politico-wonk on the radio say, on the subject of commissioning, those dreaded words: ‘We're giving GPs these powers because they're at the front line of medical care – they know the needs of their local population.'

That did it. I've heard this clichéd claptrap spouted as justification for the proposed NHS shake-up so often that, I swear, the next person guilty party I'll assault with a traffic cone and some KY jelly. This phrase, insisting that we GPs are somehow blessed with demographic insights and population-health super-powers, is trotted out as though it's some incontrovertible truth which explains everything. It isn't and it doesn't.

In my day job, I see lots of people with, say, sore throats, high blood pressure and diabetes. So I know that, in terms of sore throats, high blood pressure and diabetes, there's a lot of it about – but that hardly gives me a global view of my local population's health, not least because the majority, most of the time, don't bother me.

I also encounter a vocal and assertive minority happy to tell me what their health wants are, but that tells me nothing of their health needs, nor does it reflect the views of the quieter majority. It's not even as though I have much clue what baseline service provision is like, because initiatives, clinics and outreach teams come and go every week: yesterday there was a crisis support team to help avoid admissions, but today the funding's pulled or the nurse is off sick, so instead of solving a crisis it creates one.

Besides, my list comprises about 2,000 patients. The average fourth wave consortium has over 230,000 – so my patients comprise less than 1% of the total. No wonder I feel I know nothing about commissioning-level health needs. And even if I really did have a handle on my local population, the demographic and needs of a practice just down the road could be completely different.

All of which means that the mantra about GPs being local health needs oracles is lazy, hackneyed rubbish which, for some reason, we all seem happy to collude with. That was why I was screaming at the radio.

If I start barking at trees, I'll let you know. And as for the little old lady, yes, she was dressed as a clown.

'Sick Notes' by Dr Tony Copperfield is out now, available from Monday Books

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