Governments always use catastrophes to increase their power, and in the NHS we have seen a number of significant policy changes that have been introduced in order to achieve their aims.
In general practice we have seen this coming for a while, and the murdering exploits of a psychopath who happened to be a GP has been used (with the help of a legally qualified stooge) to develop a process of control of all doctors, with the introduction of the system of revalidation. Ostensibly, this was to ‘prevent another Shipman happening’, but is actually about subjugating a whole profession.
Revalidation is now, finally, upon us. The first version of the process will be cuddly, and non-threatening, and colleagues will say to me, ‘What are you worried about? – I’ve done it and it isn’t too bad.’
They are correct in what they say that the first version will not be too arduous. We will get revalidation creep: in five years you will have your use of social media supervised, and your non-work activities monitored. If you are a whistleblower, reporting poor care or management decisions that directly damage patients, there will be ways found to silence you such as threatening your registration.
Much in medicine still fascinates me, and as I approach the end of my career, I feel genuine regret that I am finally hanging up my stethoscope. At the age of 60, I have many years of usefulness ahead of me. However, all this has been ground out of me, and I am leaving medicine altogether in 13 weeks’ time.
When I qualified, the essence of being a professional person was that you behaved and acted like a professional doctor, you always did your best for your patients and worked the time that was necessary to do the job. You never looked at the clock, and just got on with it. You were answerable to your patients, the reputation of the hospital or practice, and were judged by your peers.
I remember the old General Medical Council. It was pretty much of an old boys’ club, but there were people on it who were the best in our profession, and who I looked up to. We were able to elect the membership of the organisation, and that gave it a democratic mandate, and the respect of the profession.
The GMC hasn’t been perfect and has made mistakes down the years: some said that it over favoured doctors, and closed ranks and protected us, but it never felt like that to me. I am pleased that I have never had any direct dealings with it. I hope that it stays that way.
Now, if you look at the GMC it has no democratic mandate, has a minority of the profession on the committees, and takes its orders from the Department of Health. It is simply a branch of the executive, and control has been wrested away from the profession and given to civil servants and politicians. This may not be formally de jure, but it is de facto.
The introduction of revalidation is the reason I am finally retiring, and not staying on to give my expertise and knowledge to medicine. It feels to me like a betrayal of the whole profession, and we have allowed ourselves to be manoeuvred into a position of weakness and vulnerability, and have debased ourselves as professionals.
This process could not have happened without the acquiescence of senior members of the profession. They are guilty of collusion in this control-freakery. We are left to rue the damage this will do.
The Jobbing Doctor is a GP in a deprived urban area of England. You can follow him on Twitter @jobbingdoctor.