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An invitation to Wes Streeting

An invitation to Wes Streeting

Dr Zoe Rog invites the new health secretary to spend a whole day in general practice to make him understand the scale of the crisis

Our new health secretary Wes Streeting made his first official visit in the role to a GP practice in London yesterday, and said he was ‘committed to reversing’ the underfunding in general practice. It is a good start, but as a next step, I would like to extend the invitation to him to come and spend a full day with us to better understand our position and problems. Mr Streeting has already declared that the NHS is broken, so I think a day with us will show him the actual issues that need fixing, and perhaps some of the reasons we are concerned with his previous observations and suggestions.

It is paramount that any health secretary appreciates the level of complexity that GPs deal with. For example, the myriad of decisions we make every minute as we are bombarded with information from patients, staff and computer systems. At the same time, I would like Mr Streeting to witness busy GPs supervising trainees and ARRS staff, taking responsibility for their clinical decisions as well as our own. Among the crazy demands, I would like him to perceive the high quality of consultation that we still provide for our patients: the magical patient-centred ‘doctor as a drug’ interaction, resulting in patients crying with gratitude simply because we have listened and understood. 

During the day, I would ask Mr Streeting to notice how many times the EMIS ‘spinning disc of doom’ delays a clinician. I want him to stare into that technological void, mentally multiplying the time this takes; and the number of primary care clinicians and admin staff across the country all regularly halted by an inadequate clinical system that crashes and fails to interact appropriately with bolted on bits of software.

Next, Mr Streeting might care to stop problematic correspondence and workload push-back. The inappropriate letters from secondary care, OOH and urgent care asking us to inappropriately chase tests and follow-up patients for dubious reasons. Get him to go through the futile letters that we write back to heads of service and clinical directors with heartfelt pleas to stop this from happening. Letters from hospital teams asking us to provide sick notes for conditions that they have assessed, treated and are hence better placed to provide a sick note for. Deal with the patients being told their GP needs to write a letter to expedite their hospital appointment because they are sitting on an impossibly long hospital waiting list. I would also like to demonstrate the volume of work our practice pharmacists deal with in terms of poor discharge summaries and hospital clinic letters that lack clarity or demonstrate poor understanding about which prescriptions have to be initiated, retained and monitored in secondary care. All of these have tied up GP time for years and have been spoken about in many forums on many occasions, but still continue to waste our time.

I’d invite Mr Streeting to a partners’ meeting to illustrate a few more issues. Not least that there is absolutely nothing murky or opaque about the way we operate our finances; we can demonstrate exactly what has happened to every penny. They are however extremely complicated, and maybe if Mr Streeting could see the multiple agencies and portals via which we have to claim the money we have earned, (including the many emails chasing up late payments) he might prioritise thinking about ways in which this could all be considerably simplified. We might discuss how few practices fail to balance their income and expenditure – in contrast with hospitals who often over-spend by large sums. Could this pave the way for a system in which a briefer response might be deemed acceptable? 

Most of all, I would like to demonstrate the value that GP partners provide: both in terms of volume of clinical work; but also clinical leadership and managerial work. Mr Streeting has talked previously about dismantling the partnership model (though he did later retract this). But the initial statement showed a failure to understand how difficult and costly his lofty ambition would be to enact and replace. We might also remind him about previous costly changes that governments have made, such as removing out-of-hours care responsibility from GPs and GP co-operatives in 2004, which resulted in a more expensive and lower quality out-of-hours service. Dare we hope that he might draw the conclusion that GP partners could be trusted to spend money wisely without it being ring-fenced and tied to conditions that prevent us from spending it in the most efficient way?

As usual we will get to the end of the day with many things outstanding. We haven’t even discussed the inefficiencies of mandatory training and appraisal. But, if Mr Streeting will continue to engage with us, endeavour to understand what we do and how we do it and fix even some of these problems, the future might be a little brighter, with the NHS on the mend.

Dr Zoe Rog is a GP in Runcorn, Cheshire 



Please note, only GPs are permitted to add comments to articles

Dave Haddock 9 July, 2024 6:45 pm

Starmer promised the new Government would “hit the ground running”; but what he actually meant by “running ” was “running around like headless chickens”.
Wes is clueless. He needed his remedial class with Dr Rog a year ago, with weekly updates as he appears to have problems with remembering last month’s policy u-turns.

Out of here And happy 9 July, 2024 8:48 pm

Life long Tory voter – voted labour
Give him at least a chance ….. how many days we in so far ??? Tory’s had 14 years to sort it and ………..

Josephine Fleming 10 July, 2024 12:22 pm

Sadly because he has been to see his GP for various reasons over his life time, he feels he ‘knows what GPs do’ I hope he takes up the offer to see what really happens and also takes it on board. I was asked by the Labour party to fill in a questionnaire from my perspective of being a GP and then asked if there was a quote I could offer – it was ‘ Please don’t assume you know what a GP does just because you have been to see one as a patient – after all the public may think politicians do little as they are only sitting in parliament for a few hours a day ‘

Dave Haddock 11 July, 2024 4:46 am

Give Wes a chance?
He’s been Shadow Health for two – three years, but still has no coherent policies.What has he been doing?
You can do a degree in less time.