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‘Everyone needs to know where the buck stops for their care. And the buck stops with you’

“Before I begin I’d like to thank the staff of Crapston Health Centre for allowing me to speak in this lovely building this morning.  It’s amazing what they could do with cement back in the 1970s.

“I’d particularly like to thank all those GPs who are taking early retirement today. They’ve made an outstanding contribution over many years of dedicated service and I wish them all the best for their retirement including many happy hours their spouses will no doubt spend visiting their final resting place.

“Our primary care system has long been respected and envied. Much of the primary care delivered all over the world today was made in Britain: blood pressure was made in Britain, asthma was made in Britain and thanks to Britain millions of people all around the world are sneezing non-stop because of the hayfever that we invented.

“And the celebration doesn’t stop there. The Commonwealth Fund ranked the UK as the best in the world for quality, although it ranked us as one of the worst in the world for mortality. We’re doing well but it seems that we just can’t keep people alive.

“Less well-known is that when you dig deeper the areas where the UK amassed its fortune was on the quality of general practice. 

“I can say, without the slightest hint of irony, that general practice is indeed the jewel in the crown. A glittery shiny jewel, a jewel which is the envy of…

“Oh who am I kidding, it’s a bag of sh*te.

“And as a result we’re going to have to introduce some radical changes because we’ve undervalued, underinvested and undermined the work you do over many years.

“Doctors come to me all the time and say: ‘I feel like a hamster trapped on a wheel of 10-minute appointments. What are you going to do about it?’, and I reply, ‘A man-sized hamster! With big furry cheeks and slim little hands trapped on an enormous wheel? How weird!” and I usually find that this helps.

“The uncomfortable truth is that within five years everyone in the UK will either be a hamster or they’ll be at least 90 years old.

“And I intend to leave no turn unstoned as I look everywhere for people that can do the sort of things that you can do, only not as well as you. 

“Which means we’re going to recruit pharmacists and physician associates, that’s right, we’re going to save general practice by employing people whose only qualification is a first aid course and a box set of Holby City.

“We’re going to increase the number of unfilled training places by telling medical students that general practice is just fabby and we’re going to start begging people who have seen the light to come back from Australia.

“We’ve already had an 82% success rate, but it’s not up to me to define what success means, I just like the word.

“In support of the profession I’m also going to give frequent press releases saying things like, ‘We need an integrated enhanced service structure employing a flexible, digitally balanced work-force skill mix’ and then ask you to tell me what you think it means.

“Now to you. We’re going to tackle burnout head on. We’re going to tackle burnout by making practices open seven days a week and we’re going to give you the tools so that you can manage the incessant demands of a 24/7 culture and the mountain of paper-work that you face every day, tools like a rope, a job lot of paracetamol and a hose pipe.

“Everyone needs to know where the buck stops for their care. And the buck stops with you.

“That’s my commitment to you, now I want you to commit to me. Because before you burn out or leave for Australia you need to turn my hollow rhetoric into something workable so that I can keep my job.”

Dr Kevin Hinkley is a GP in Aberdeen.