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We should all be chucking our physician associates out of our prams



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I’ve just been to one of those GPC new contract roadshow things. Now, I know that I’m paid to react like Private Eye’s ‘Angry baby’, which might surprise you (the being-paid bit), but really, I’m furious! Where is the dissent, the militancy, the smell of revolution?

It wasn’t where I was sitting. Everyone was nodding and grunting approval in a sort of comfy, hypnotised daze as they heard about the list of subsidised staff our networks have been promised. Whereas I was writhing around like a colicky, inconsolable neonate. Why? Well here, off the top of my head, are some of the things from the ‘Additional roles’ section of our brave new world that have knotted my intestines:

  • Clinical pharmacists, social prescribing link workers, physician associates, first contact physios and community paramedics are not doctors, although the clever use of words like ‘clinical’, ‘prescribing’ and ‘physician’ are designed to obscure that fact.
  • I made it clear what I wanted from this new contract in the same way that I make it clear to Santa Claus each year what I want for Christmas, and my list was an unambiguous ‘GPs and less workload’. The outcome in this case might make the giver think, ‘job done’, and might elicit from the recipient a display of false but polite gratitude, but we’ve still ended up with a sack-full of cheap knock-offs.
  • As far as I can tell, these workers are being sequentially pointed in our direction largely because, according to the proposed timetable, they might be available.
  • I already have a pharmacist, and access to both social prescribers and physios, ta very much. I don’t need a physician associate or a paramedic. But I do desperately need mental health workers so, obviously, they’re not on the list.
  • All these new staff will need training, mentoring, monitoring and housing etc, so they will generate workload before they start reducing it, at which point they will probably go off sick, with their roles defaulting, of course, to the GP.
  • The subsidy for their salaries will only continue if we jump through hoops which are very high, doused in petrol and set on fire.

And so on. Come on. Why are we lapping this up? It’s just a pathetic bit of misdirection, we should be throwing our teddies out of the pram, and it has made me go very red in the face. Pass me the nappies, would you?

Dr Tony Copperfield is a GP in Essex

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