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If the NHS has to be trimmed, then spare the curlers



Travelling for me is not about soaking up different cultures, scenery and food whilst enjoying a break from work or studies. It’s also about getting a haircut. Whilst we are not in short supply of coffee shops and Turkish barbers on our local high street, there is no better way to get a feel of the day to day life when abroad than by getting a quick trim. I love to search for a run-down barber shop to see how the locals go about their daily business.  A street haircut in Vietnam? No problem. Freshen the quiff and have a massage beside a Nepalese lake? All yours for 20 pence. Off with the beard in the Andes? Take a seat.

Our system is good

The point here is that different countries do things in different ways, and experiencing that adds to life’s rich tapestry. Medicine is no different and whilst patients will present with similar problems the world over, the organisation and provision of healthcare will vary hugely. So, have we got it right in this nation, this newly isolated UK and can we learn from further afield or our recently divorced European friends?

Well there is probably no perfect system but that doesn’t mean we cannot strive for one. Primary care is under pressure with recruitment and retention being major problems. Junior doctors are voting with their feet and leaving in droves for greener pastures, as well as more senior colleagues taking their pension at the earliest opportunity. I, too, have worked overseas prior to settling in my practice 19 years ago, having been to Australia and got the T-shirt (actually a driza-bone), twice in fact, and I learnt a great deal about medicine, life and healthcare.

But what I took for granted in the UK – single medical record, continuity of care, a responsibility to provide 24 hour care and home visits along with palliative care – was not the norm Down Under back then and it left me appreciating how great our current system is. The fee for service model leaves a lot to be desired and aspects of this can easily creep in to our fragmenting service and in my view we will need to be very cautious not to let this happen.

Apart from wonderful weather, beaches, food, geography, work-life balance, windsurfing, wildlife, sporting facilities and a relaxed living environment, Australia had nothing to offer me!

Our system is good. Fund it properly, kick out the red tape, and reduce the box ticking and we could have a fantastic facility again. Our CCG currently holds over 400 primary care contracts covering the basics and enhanced services. Imagine the hours spent monitoring that – we happily abolished the red book in 2004 to reach the promised land with less reporting and boxes to tick. Oh how we laugh.

I have no idea what the next few years will hold for our wonderful NHS – I worry that the focus will be elsewhere politically now and while our NHS enjoys its biggest haircut of all time, I make a simple plea for primary care contracting and funding as we digest the latest contract offering. Keep it simple. No perms or highlights. Ensure patient safety, trust primary care, cut the crappy monitoring, lump funds together, value the workforce, and enable GPs to do what they do best – look after patients.

Dr Richard Cook is a GP partner in Hurstpierpoint, West Sussex. You can follow him on Twitter @drmoderate