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Yes, Sarah Baxter, we do need GPs



I have more than 30 years’ experience of being a GP and it saddens me to hear the continual denigrating of general practice by the likes of Sarah Baxter in a respectable newspaper like the Sunday Times. 

Another day, another GP bashing. Is there a conspiracy to kill off the jewel in the crown of the NHS; ‘General Practice’ and to fatally undermine the envy of the world; ‘The NHS’? There is no doubt that we have variation in standards of primary care which needs addressing. However, by and large, the primary care model in the UK is undoubtedly one of the best.

I challenge Sarah Baxter to find a model anywhere in the world that can match the range, remit and responsibility that we provide as British GPs

Allow me to educate Sarah, about how general practice functions in Europe and beyond, where GPs spend longer with patients, such as the 20-minute consultations that are common in Holland. Or where whole chunks of clinical care aren’t even done by GPs, such as in Spain, where all smears are done by gynacologists or Hungary and the Czech Republic, where all children are seen by paediatricians, and indeed in most of Europe, where patients see specialists freely, without any reference to their GP.

Or in Sweden where out-of-hours services start at 5pm, and where, between midnight and morning, there is no primary care, and patients instead attend A&E or call an ambulance. And in the whole of Europe, no nation operates targets or makes systematic data entry, nor measurement of practice performance of chronic diseases.

Let’s see what a UK GP does; where every single patient wanting to see a specialist must see their GP first, and where we, manage bulk of patient care, as well as the continuing transfer of work from hospitals. We comprehensively provide the entire spectrum of clinical care without exception, from baby checks to the elderly, managing chronic diseases such as diabetes, coronary heart disease, heart failure, epilepsy, even renal disease, which would be completely alien to the reality of GPs in other countries. Where this information is systematically recorded with registers and exemplary standards of care, via the quality and outcome framework, that has no international parallel.

And where we have superlative trust and satisfaction ratings that tower over journalists and politicians, and where patients see us as advocates, helping them through thick and thin, from stress at work to coping with grief, and where patients even resort to phoning us from A&E or a hospital bed, pleading with us to sort out their plight. And when the system fails anywhere, from an ambulance not turning up, to a hospital appointment cancelled, or a disability benefit that’s been refused, it’s us to whom they turn to pick up the pieces. And it’s the GPs’ door where the buck stops. And we’re paid just £70 per patient to do all this, a fixed amount for an unlimited number of consultations or visits per year, where in spite of this we prescribe more cost effectively.

Moreover, we do this with fewer GPs per head than most of Europe. I challenge Sarah Baxter to find a model anywhere in the world that can match the range, remit and responsibility that we take on and provide as British GPs. Our system of general practice offers an amazingly cost-effective service with a quality of care that is second to none. The GP bashing, which is now an almost daily feature from certain section of media and politicians needs stopping. This current animosity for GPs is so politically driven. They are so overworked and undervalued. Who would want to become a GP now?