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How can Professor Steve Field say we’ve failed as a profession?



Professor Steve Field’s comments ‘General practice has ‘failed as a profession’ left me both angry and saddened. Angry, because he wrongly attributes failings of a minority of practices to malign the entire profession, and saddened because he seems so far removed from understanding the way GPs are working their socks off, to meet rising demands with diminishing resources in the primary care.

He says ’how uncaring and poor some of the practices have been’. To make such sweeping inflammatory statements, and to the Daily Mail of all places is, to say the least is very unhelpful when the profession is going through such a ‘crisis’. Failing practices are running into difficulty primarily due to recruitment and retention crisis, and that is not the fault of the profession. I don’t know what his motives are for denigrating the profession at such a crucial time, I assume, that either he is become so much part of the official machinery that he forgets he once was chair and president of the RCGP. Maybe he is justifying in advance the extortion of GP inspection fees which is being proposed.

Professor Steve Field needs a reality check

Professor Steve Field – do you realise that general practice has become an under-resourced, over-stretched shell of its former self, struggling to keep pace with patient demand despite the efforts of staff? This mismatch between reality and politicians’ promises is a real threat to patient services in the years ahead. That is what you should be highlighting, rather than saying ’you are ashamed of being a GP’.

There are now 7,962 GP practices in England – one in 20 has disappeared since 2010. The rate of loss of local surgeries has speeded up – 79 closed and 55 opened in 2010 but in 2013, 126 closed and only 13 opened. There has been a five-fold rise in the number of GP surgeries approaching senior NHS managers for advice about shutting their doors or merging with nearby practices. There is a limit to what GPs can do when patient demand is going up and resources are going down. With an ageing population that needs more complicated care and longer appointments, this is only going to get worse. Professor Steve Field needs to understand that what GP services need is a long-term, stable plan that gets them back on an even keel. This means better funding and a sensible recruitment plan, not political statements to please his bosses.

We GPs went into medicine to make people better. We don’t want to see the standard of care we provide eroded by ill-thought-out political objectives, without any proof. General practice is the bedrock of many NHS services and the gatekeeper to the rest. You can either provide the meaningful leadership, confront the realities facing GP practices and make plans now to meet growing challenges, or you can bury your head in the sand and let this key part of the NHS slide into permanent decline with your ill thought remarks.

Dr Kailash Chand OBE is the deputy chair of the BMA, and a retired GP. He writes in a personal capacity.