Tuesday, February 27, 2024

The Good Doctor’s Blog: Pouring scorn on David Cameron’s reforms

The Good Doctor’s Blog

12/7 GP appointments Promised by Cameron

Will your next GP consultation be with a Russian speaking GP and an interpreter?

THE news media has been abuzz with Mr Cameron’s plan to ensure that GP surgeries open 12 hours per day 7 days per week. Mr Cameron dedicated £50M earlier this year for pilots to test his idea. Strangely 1/7th of that money was spent on admin within the NHS. More strangely, although we do not know the outcome of these pilots, Mr Cameron’s mind is already made up. What was the point of the pilots? Publicity? Political manoeuvres?

I am an out and out Conservative and believe that the NHS, as well as the rest of the economy, is safer in conservative hands. However, I do not mind saying that both main political parties have played political football with the NHS, promising what has been poorly thought out, launching what is unaffordable, and espoused completely illogical policies. Not because they are stupid. But rather because of the hidden agenda of vote-winning. They have a habit of announcing what sounds popular rather than what is genuinely good. There is no doubting that the idea of 12/7 is popular with the voting public, as all surveys indicate that patients want more of everything, including GP appointments. There is the issue of greater supply creating greater demand. But, I will pass on the question of whether we actually need 12/7 GP appointments. The question is how feasible is Cameron’s idea?

The truth is that public demand for appointments in general practice has doubled in the last ten years. Yet investment in general practice has diminished by 8%. What this tells us is that somehow politicians believe they can squeeze general practice harder. The constant unreasonable pressure on General Practice is making it an unpopular option for young doctors. Deaneries are failing to fill GP training positions. GPs are retiring early. And all politicians can do is squeeze GPs harder. Does that mean that politicians want more for less, as they have been accustomed to do with GPs?

Mr Cameron is talking about investing a few hundred million pounds in general practice. In reality, we need to spend a couple of billion pounds on additional GP positions, let alone associated staff such as nurses and receptionists. Premises are another story of shame and infamy. The CQC is shutting practices down because they are not fit for purpose. And whose fault is this? It is our politicians, who from the outset of the NHS decided to ignore GP premises.

I had to fight 10 years to secure modern premises in Tilbury and Grays. It was a totally exhausting demoralising experience. The PCT’s support was half hearted at most, failing to deliver on several promises, refusing to support me for funds that come from the central NHS. It would not have cost the PCT any money. How is the NHS going to provide modern premises with a puny investment?! The average man in the street may be dazzled by Cameron’s promise of a few hundred million pounds. But those at the coalface of general practice know very well this promise is woefully inadequate.

The Prime Minister wants GPs to commence this service by 2020. He believes it would relieve pressure on hospitals, which we have confirmed in my practice with a non-funded pilot. But one must ask why wait till 2020? If extending GP hours would relieve pressure on hospitals, thus saving oodles of pounds, then why wait till 2020?! The savings from reduced hospital pressure should, at least partly, pay for the additional GP hours.

Finally, Cameron is essentially asking to double GP hours. How the dickens can any country double the number of GP’s in five years? Especially when general practice has been made so unattractive a career option, by politicians! It takes an average of 10 years to produce a qualified GP. So Mr Cameron has two obstacles to overcome: time, and popularity. He can probably bridge the time gap by recruiting foreign GPs. But how is he going to make general practice popular amongst locally qualified doctors?

He needs to stop manipulating GPs and heaping all the misery of society on their back. He needs to give GPs time and other resources equal to the task his government sets for them. This involves a culture change in Whitehall. They have to stop promising a storm and delivering a breeze. If the NHS wants 12/7 GP appointments, the government needs to open its coffers and pay the real cost. Otherwise, we will find ourselves even more desperate for GP’s, as more of them will take early retirement and fewer will want to join the profession.

Alas I fear that no positive change will occur in Whitehall until patient groups come into their own and demonstrate in the streets, for a change in attitude and a willingness for politicians to put the nation’s money where the politicians’ mouth is. Or else you may find your next consultation with a Russian speaking GP and an interpreter. Oh yes, they will be available 12/7! And they might give you powerful steroids for a simple ear infection, or three sedatives and an antidepressant for mild depression, as has happened in Thurrock when we, out of desperation, imported GPs from another country, not long ago. Whilst it is at times necessary and rewarding to look abroad for labour, it is foolish to heavily rely on foreign labour.


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