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Badly done

Jobbing Doctor doesn't like the flavour of general practice that Sainsbury's and others are selling.

I may not shop at Sainsbury's again.

I am really quite cross with them for their enthusiasm for developing their dumbed-down version of General Practice. What on earth do they think they are doing?

Earlier on in the year they attempted to get a scheme running in Manchester with having a GP section in one of their supermarkets. It did not succeed, and was closed down. All of a sudden they are at it again. This is a policy that has been decided at the top of the company, doubtless with the active encouragement of the Government.

It would be good to state this fact straight out - going to see a doctor is not like a supermarket. It never will be, and that has been clearly indicated by the lady who has now taken over as the spokesperson for more than 35,000 GPs.

Why is it that so many policy makers think that general practice is merely like going to ‘pop in' to see a garage mechanic? Any garage mechanic will do.

This is because we have been shamefully represented at the heart of policy making. Our voice has been weak and thready, and (although we have a primary health care tsar), there has been no-one to represent the true view of general practice in the last few years.

The primary health care tsar. Now there is a post that requires an active clinician who is truly independent and can give adequate advice to a largely ignorant Government. Instead we have had a New Labour placeman, who worked for a while in leafy Cheshire, and hasn't been in active clinical practice for some years.

His advice is about as much use as, well, a retired apparatchik who wants to keep hold of his status.

Exactly. No help at all.

So we are now faced with the prospect of yet more people providing primary care advice. Go to the ‘practitioner' whilst you shop, and whilst that would be OK for relatively simple things, like having a sore throat, or a prescription for the pill or uncomplicated urinary tract infection, it simply will not do for almost all my patient contacts.

What about record keeping, for example, or complicated co-existent morbidities? How will that play out? What about the patients you are trying to wean off addictive medication (such as benzodiazepines), or trying to stop them having antibiotics for viral infections? They will just shop around.

The Government want to break the fantastic relationship between family doctors and patients. They even ennobled a misguided surgeon to say so. They want to get others involved in primary care.

They are granting nurses and others the ‘right' to prescribe, and are encouraging some doctors to train up nurses, and physician's assistants, and ambulance personnel to do these roles. I feel that colleagues who have agreed to train up these people have colluded with a dumbing down agenda within primary care, and have demeaned themselves.

I understand that Sainsbury's have started a series of roadshows all around the country to try and encourage practices to take on these roles in their booths in their supermarkets. They tell us that these roadshows are very popular with some colleagues.

I would advise my fellow GPs to be extremely circumspect about this whole process. Be wary. This is about what they call plurality (I call that privatisation and dumbing down) and contestability (translation: anyone can do our job).

The traditional model of general practice is much threatened at the moment. Too many colleagues have contributed to this agenda.

Badly done, my friends, badly done.

The Jobbing Doctor is a general practitioner in a deprived urban area of England.

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