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GPs need to show our hand



You remember the game? It’s a test of nerve, you mustn’t back down: loser blinks first.

It’s simple: the NHS is in crisis, and no more so than in general practice. Day in, day out the pressure is enormous. I love the job that I should be doing. I think I am reasonably good at the job I should be doing, I act safely in the job that I should be doing. But this is not the job that I should be doing.

I think it’s time we showed our hand, to let the public know what their options are

The paperwork is drowning me, the limitless demand, the shift of responsibility from everyone, everywhere to general practice. It is draining.

And is it safe? Hand on heart, I no longer feel that I can practice safe medicine on a daily basis. So what’s the answer?

We’re trying not to blink, but our eyes are watering now.

At the moment it seems the solution is that we magic GPs out of nowhere, organise and reorganise, and just hope it all sorts itself out. Or we throw a smidgeon of money at some bits of it. Not money where it needs to go, but money that you have to fight for, that goes to where the powers that be think it should go. Or is there another answer?

Eyes straining: we… must… not… blink?

But this this game has gone on too long. The NHS is being starved, this is becoming all too clear, even senior Tory MPs like Dr Sarah Wollaston are highlighting the misleading investment figures.

One solution: general practice needs money in its core contract. Stabilise general practice you stabilise the NHS. So the answer is you increase taxes to pay for it. Simple.

Except no politician will suggest that, and few voters will agree to it. So what next?

It’s the final part of the match; we’re never going to win. It is clear that in this competition, the other side has bilateral Bell’s Palsy.

We blink

It is high time someone raised and discussed our options, however unpopular they may be. If the answer is not taxes, what else? What are the alternatives? The Government refuses to blink, so perhaps we need to force their hand and work up safe, sustainable, alternative models for the funding of general practice. I was therefore encouraged to see the announcement this week that in some areas of the country, a ‘Plan B’ to take GP practices outside the NHS is being discussed.

Please don’t misunderstand me (I’m looking at you ‘anonymous healthcare professional’ commenter), I work in an inner city practice and see deprivation day in and day out. I see the consequences of welfare cuts and part-privatisation. I don’t want a two-tier system of health care, I don’t want the most needy getting the worst care.

But what I do want is stability, and safe, quality care for doctors and patients alike. I think it’s time we showed our hand, to let the public know what their options are. To demand what we really need, open and honest debate on the future of general practice.

No one else is blinking on this issue, and until they do it seems covert privatisation and collapse of NHS general practice is inevitable. Sold to the highest bidder solely for profits not patients.

Let’s not allow that to happen. I look forward to Plan B.

Dr Susie Bayley is a GP in Derby and chair of GP Survival. You can follow her on Twitter @susiebayley