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Planes, trains and general practice

Last year‘s Pulse Live was so good that I swore I’d walk ten miles barefoot over broken glass to get to the next one. And thanks to the sodding tube strike, that’s what I’ve just done. And that’s also why I missed the new editor’s opening comments.

I did arrive, though, to hear the words, ‘NICE guidelines don’t really work for patients with multimorbidity’. And also that `there are more people with two conditions than one’. Which I think adds up to, NICE gudelines don’t work. Who said that? Only David Haslam, the chair of NICE.

As ever, he was right on the money in his state of the nation address, with ‘NICE guidelines are guidelines not tramlines’, ‘medicine is something we should do with patients not to patients’ and ‘there is too much work and too little time’.

All of which led very neatly into the debate, ‘All GPs should be salaried employees of the NHS’. There was a brief debate about whether a debate could be a debate if there aren’t speakers on either side of the topic – resolved by the 11th hour arrival of the speaker.

By the end,there was – literally – one person left voting in favour of a salaried service. And even though it was an unfair, two-on-one fight, that was a resounding victory for those who think, to quote one speaker, ‘We should grumble on as we are.’

Now for coffee and a foot-soak.

Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield