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Dr Michelle Drage: Where’s the money and what are the strings?

The report feels like they’ve listened to what we’ve been telling them for the past two years, but it feels like some of these might be a bit of a tease.

Because it looks a bit like a revamped Healthcare for London in some respects, and the concerns we have are around premises now, not around premises in five years’ time. So it’s a question of where’s the money and what are the strings?

The report pays attention to workforce, but doesn’t really identify what the issues are.

It doesn’t really talk about building community services, and diagnostic services around general practice to keep people about of hospitals. And then it opens the floodgates around, if services aren’t good enough it will bring in alternative providers.

And it also talks about getting rid of the rent and rates scheme, a national arrangement, and coming up with some other concoction that they haven’t discussed.

It says if you don’t upgrade your premises to meet the disability requirements, which often GPs have struggled to do without support for the past 15 years, they’re now going to be clobbered by saying, “we’ll move you”. 

So what we need to see is upgrades to our premises now, not the promise of a move to what may well be an old dilapidated hospital site in five years time.

So I’m very, very sceptical about some of the teasing promises and the ability to deliver in a way that makes sure GPs and their patients provide really good quality services that patients need, as opposed to what the system planners decide is necessary.

I accept there is a recognition of what we’ve been saying for many, many years, and particularly loudly for the past two years.

It’s a recognition, but we don’t know where that money is, we don’t know where it’s coming from, so it feels like a tease and we need to be well involved as GP providers, not as commissioners, because we know what our patients need.

So there is a lot underneath the headlines still to be seen.

But it’s really important that Londonwide LMCs is involved in the implementation of things to keep them on track, just like we have been involved in the development stage trying to steer GP’s concerns into these broader recommendations.

We need to be right in there, making sure we don’t – under the view of the big picture proposals – lose some of the quality and really good, dedicated, work that our GP surgeries and practice teams are doing, because they feel unsupported.

We need to keep a seat at the table.

Dr Michelle Drage is chief executive of Londonwide LMCs