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Define the future

5th January 2017

Live Health News  |  Weather  |  Archive 

Wyman, chair of the CQC, in conversation with Roy Lilley
24th January - King's Fund, 5.30pm
A few tickets left.
Define the future
News and Comment from Roy Lilley
The Royal College of GP's has a new leader.

There is an old world feel to Royal Colleges.  The chain of office, high table and a whiff of Freemasonry...  

Given the preoccupations of GP-ing, my guess is, only the most determined, political-doctor will be bothered. 

The latest incumbent is Helen Stokes-Lampard.  A curious choice insofar as she works only one day a week as a GP, at a practice that closes for 'protected learning time' and as far as I can see, has no Saturday or Sunday services. 

Intriguing because Helen S-L is making a bit of a thing about opening times and seven day services.

Elevated by the press to the role of 'Britain's most senior doctor',  (really?) HSL rehearses the boarding-house margarine complaint; 'spread too thin'.  Doctors, I mean not the Stork.

The DH rightly say; "People don't just get ill Monday to Friday, nine to five."  Apparently, 18 million patients now have weekend and extended access to a GP, which, the DH claims, "has already shown evidence of relieving pressure on other parts of the NHS."

I think I've said before; for many of us, driving to A&E, parking easily, getting in, getting diagnosed, getting fixed up, getting out and getting on with our lives, even wth a four hour wait... is a better prospect than HSL's prediction of having to wait four weeks for a GP.

According to a poll of 500 GPs in Tuesday's £Times, 61% believed surgeries should be opened in A&E.  Given the shortage of GPs, I take that to mean closing surgeries elsewhere?  

I remember, very fondly, the family doctor who saw my working-class family through the dark days of rationing, illness and death.  When he died we went to his funeral.

He wore a waistcoat, we wore jumpers.  He had cuff links, we rolled up our sleeves. He was warm, a listener.  We took our troubles to him.  

When I was four his diagnostic skills saved my life and at 3am, he drove me and Dad, to A&E.  The first time anyone in my family had been in a car.

I have no axe to grind with primary care but I do have a point to make.

If the RCGP's new leader is right, primary care is facing its twilight days.  Finished.  We are asking too much.  Top doctor Helen says it can't be done.  She must know, she's the 'top doctor'.

Tread carefully.  There are over one million primary care contacts a day; 98% of first contacts for under 9% of the budget.

Let's face it GP practices are small businesses.  You can't run any business without enough money, qualified staff and a level of demand that is sending 'customers' elsewhere.

Continuity of care, familiar faces evaporating with part-time GPs, locums and crammed appointments.  There is a £2.3bn investment in primary care promised by 2020.  Too late?  If it was brought forward, how would we spend it?

App's that give Face-Time access to a GP-anytime are routinely advertised on TV.  As common as pizzas and no-win-no-fee lawyers.  Jersey GPs provide one for their patients.

Leadership is about vision, ambition, discipline, inspiration.  It's also about restraint.  

The idea that leadership is haranguing government or stating the obvious is, frankly, nonsense.  What is the answer?

Tough times don't last, tough people do... 

These are troubled times.  Government is weak, preoccupied, the economy fragile.  The opposition rudderless.  The future uncertain.

Mrs Maymite and her friends are not interested in the NHS.  They are impervious to front-page insults, even from doctors.

Qualities of leadership require more than shouting 'we are going to hell in a hand cart'... that is not a vision.  It's a statement of the obvious.

Demanding more money, insisting on polishing up the past will achieve nothing but isolation and hollow, conference speeches to the faithful.

Helen, we know it's a mess.  I agree but beyond complaining, moaning, making a fuss... what are you going to do?

Federations, primary-care-unplugged, nurse-led practices, GPs in A&E, paramedic-clinics, practices in Mother-Care, Tesco, surgeries on stations.  GPs on the phone, FaceBook, in the pharmacy?  Call-centres, vertical integration?  Artificial intelligence! Strike, work to rule, withdraw cooperation...

How will you define the future?   
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