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What is our currency?



My kids have been able to define the word consequences since the age of two. When they were very little, tantrums and fighting would lead to the naughty step. A little older and they were banned from treats. Nowadays it’s a ban on screen time and puppy training. I am always on the lookout for new currency I can bargain with, in exchange for correcting inappropriate behaviour.

I am writing this as I reflect on events over the last few days at the annual LMCs Conference in Edinburgh. It was only the third such conference I have attended, so although not a virgin, I was still a relative newbie. In spite of this novelty, it was all starting to feel a little bit like Groundhog Day.

There were the usual faces lamenting the usual topics – indemnity, funding, workforce, over-regulation and demand. Motions were passed, as in previous years, never to be mentioned again until the following year. All in all, it appeared we were voting on sentiment, as opposed to any action.

So why is there no action? What is our currency to manage the bullying behaviour of our current government? Motion S20 from last year’s conference – demanding that GPC ballot the profession on potential action including mass resignations – was one form of currency which was followed through only by our Northern Ireland colleagues. So why do we have unanimous support for certain motions, only to find them archived in the LMC libraries?

The answer is depressingly simple. We have lots of currency but no consensus. Imagine my kids being told they have no more tablet time for the week, only to find my husband has lent them his iPad. The resulting behaviour is likely to require the services of Super Nanny.

If it takes two whole days for only 300 GPs to pedantically debate the fine print of these motions, how on earth can over 50,000 GPs reach a consensus about what our currency should be?

A recent unpublished GPC survey confirmed the dysfunctionality of our profession. As a form of protest, the majority of GPs rejected the notion of stopping non-core work; work we are not even paid for. So forget undated resignations and an out-of-hours boycott – these guys won’t even stop doing the pre-op work up, which forms part of the hospital tariff.

So where does the fault lie here? Is it down to the greedy and self-centred GPs who cannot see beyond their own noses, or is it down to a pitiful lack of engagement by many of our leaders? And as an LMC board director, I now include myself in the latter group. I was merrily discussing, debating and voting on motions but not once did I stop to consider how my constituents would like me to vote.

So I’m caught up in the classic dilemma of a politician – do I make decisions by committee, or have I been voted in to use my own values and beliefs to represent my constituents?

I guess it all comes down to the different facets of good leadership. The right hand needs to be listening, communicating, engaging and collaborating. But the left hand needs to be strong, decisive and brave. It’s only when these two hands come together in an embrace that the masses will follow.

We need our very own Super Nanny to bring the profession on side, whilst showing this government who is boss. And even then, there’s no guarantee it will work because we are a divided profession.

So whatever our currency is – we need it to unite our profession. Without this unity, I fear our currency will tumble further than a post-Brexit pound.

Dr Shaba Nabi is a GP trainer in Bristol