If I could sum up the feelings of most GPs I have met over the past year in one word, it would be ‘frustration’. The profession feels that it is being failed by an establishment that does not understand (or wish to understand) the depth of the problems in general practice.
Take the biggest event of the year – the announcement of a ‘state-backed’ indemnity scheme to ‘stabilise’ costs for GPs in England by health secretary Jeremy Hunt at the RCGP Conference in Liverpool.
In usual times, this kind of announcement would be met with unqualified delight. But the response I observed both inside and outside the hall was undisguised suspicion. One questioner asked – to Mr Hunt’s visible discomfort – why after so many warnings is the Government only acting now. ‘Why should GPs believe what you are saying today?’ she asked.
Of course, this distrust does vary across the country. In Scotland, GPs are looking at a new contract that will have them working much closer with the rest of the NHS, whereas in Northern Ireland they are busy collecting resignation letters. Across England too, there are varying degrees of happiness in terms of the outputs of the GP Forward View. Many do not see any difference, others are observing promising change.
Words about how important general practice is are undermined by piling more work onto the profession
Perhaps I should be more generous to the ‘powers that be’, given that they are trying to turn around a situation that they have inherited without being given adequate resources to do it. But this is not all about money. It is about will and a change in the attitude that the health service has towards general practice.
Words about how important general practice is are undermined by – sometimes in the same breath – piling more work onto the profession. The health service should challenge the assumption that ‘business as usual’ is acceptable when patients are waiting up to three weeks for an appointment and practices are closing. It should admit that offering a pharmacist or a physician associate is not enough, when a fully trained GP is needed. It should threaten Capita with the cancellation of its contract unless its performance improves – and fast. And it should not give the green light to disruptive ‘innovations’ which undermine long-held principles of general practice.
Why? Because the current level of unhappiness in the profession is crucially important. One of the other big news stories of the year was the continued struggle of the authorities to reverse a decline GP numbers – despite promising 5,000 more by 2020. The current solution is to import 2-3,000 of them from Europe, although that will help, it will not fix the problem.
A permanent solution is to make the job bearable again. Chuck out all the things that GPs do where there is no evidence that they improve patient care and encourage those that do. I am sure your average GP could come up with a list, but here are a few ideas from me: review revalidation, chuck out CQC inspections (except for the most risky) and put seven-day access on hold.
Doing these things would cost nothing, and they might just convince a few thousand GPs not to retire, reduce their hours or resign their contract. We are about to enter a new year, and there is still time to make it a happier one for GPs and the health service which relies on them.
A very Merry Christmas from myself and all of the Pulse team.
Nigel Praities is editor of Pulse. You can follow him on Twitter @nigelpraities